uc 

490 

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.    1        (~  V-,       -P  r-.  r-  j- 


Sputhern  Branch 
of  the 

University  of  California 

Los  Angeles 

Form  L-1 


This  book   is  DUE   on    the   last  date  stamped   below 

1923 


gUL3  0 

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^^^  1  9  1932 
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SEP  2 


APR  13  1951  i 


MAY  1  3  1 


Form  L  'J-5hi  7,"22 


0 
A  MANUAL 

ON 

FOOT  CARE  AND  SHOE  FITTING 


MANN  AND  FOLSOM 


U.  S.  Marine  with  full  equipment.     Complete  weight  of  equipment  87-90  lbs. 


A  MANUAL 

ON 

FOOT   CARE   AND  SHOE    FITTING 

FOR  OFFICERS  OF  THE  U.  S.  NAVY 
AND  U.  S.  MARINE  CORPS 


BY 

W.  L.  MANN,  Ph.B.,  A.m.,  M.D., 

LIEUTENANT-COMMANDER   (M.C.)   U.  S.  NAVY;    POST  SURGEON,  MARINE 
BARRACKS.    QUANTICO,  VA. 


S.  A.  FOLSOM,  M.D., 

LIEUTENANT   (M.C.)   U.  S.  NAVY;    MEDICAL    OFFICER  IN  CHARGE  OF  ORTHOPEDIC 
DIVISION,  MEDICAL  DEPARTMENT,  MARINE  BARRACKS,  QUANTICO,  VA. 


WITH  58  ILLUSTRATIONS 


PHILADELPHIA 
P.  BLAKISTON'S  SON  &  CO 

l(i\  Z   WALNUT   S  TKHI:  I 

3^^  0  ^ 


Copyright,  1920,  by  P.  Blakiston's  Son  &  Co. 


Tll-E     MAI-LK     FRKSK     YORK    PA. 


^f  UC 


We,  as  officers  of  military  organizations,  "are 
concerned  to  prevent  the  loss  of  even  that  one 
man  in  marching,  and  this  can  only  be  achieved 
by  infinite  pains  and  attention  to  a  host  of 
details,  each  triviai,  in  itsrlf." — Lei.ean. 


PREFACE 

An  opportunity  has  been  taken  to  present  some  of  the 
results  of  our  experience  on  this  Post  for  the  consideration 
of  the  Hne  officer. 

The   numerous   demands  made   upon  the  modern   officer 
renders  it  difficult  for  him   to  devote  the  proper  time  to 
pO  the  important   subject  —  Care  of  the  Feet  of  His  Marching 
,    Command. 

.         It  is  hoped  that  the  preparation  of  this  little  publication 

will  ser\'e  as  a  guide,  a  source  of  reference,  and  at  the  same 

time  ser\'e  to  create  an  interest  in  this  subject,  causing  the 

reader  to  realize  the  relative  importance  of  the  same.     Should 

;    this    result    be    accomplished,    it   will    jjrobably    justify    the 

"  cxi:)enditure  of  the  energy  involved. 

There  is  little  claim  to  originality,  as  the  data  have  been 
)  compiled  from  a  varictv  of  sources. 

I 


INTRODUCTION 

Mobility  and  motility  of  an  organization  has  been  and 
continues  to  be  one  of  the  prime  requisites  for  military 
successes. 

Notwithstanding  the  extensive  motorization  of  modern 
armies,  the  results  of  the  recent  war  tends  to  demonstrate 
that  pedestrial  motion  still  remains  a  vital  factor  in  bringing 
the  units  into  tactical  and  strategical  positions. 


CONTENTS 

Page 

Value  of  the  Proper  Foot  Care    .    .                  i 

Orthopedic  Organization 2 

Orthopedic  Surgeon ...  2 

Foot  Inspectors - 

Responsibility  for  Proper  Fitting  of  Shoes 3 

The  March 3 

Tendency  to  Procure  a  Smaller  Shoe  than  Necess.\rv         .    .  6 

Anatomy  AND  Physiology  OF  THE  Foot 7 

Developing  the  Feet  of  the  Recruit .14 

Anatomy  of  the  Shoe ix 

Care  of  the  Shoes 20 

Badly  Fitting  Shoes 20 

Shoe-fitting 2,^ 

Fitting  and  Care  of  Socks  -?> 

Care  of  Socks 26 

Military  Foot  Inspection 27 

Technique  of  Treating  Mincjk  An. mem. s  ok  ihe  Feet.  -'8 

Cleanliness  of  the  Feet 29 

Blisters  and    Aurasion^  32 

Foot  Strain .^5 

Hallux  Valgus .V'^ 

Hallux  Rigidus  (Rigid  Great  Tol;    .  -!<> 

Hammer  Toe 41 

Deformity  of  the  Little  Toe.     .    .    .  42 

Ingrowing  Nails \2 

Sweaty  Feet  (Bkomidrosisj .1,^ 

Corns  CHokny  Thickenings  of  the  Skin;  -14 

Conditions  Affecting  the  Anterior  Arch  47 

Affections  of  the  Heel 49 

Pes  Planus  (Flat-foot) .si 

Pes  Cavus  (Hollow-foot).    .  ,s(j 

Pedographs  (Foot  Imprints;  oo 


XU  CONTENTS 

Pagk 

■f  SiioK  Fiihnu 74 

Comparison  of  Marine  Corps  and  Civilian  Lasts 74 

Causes  of  Misfits 77 

Consideration  of  the  Ball  Points  in  Fitting 78 

Consideration  of  the  Variation  between  the  Left  and  Right 

Foot 79 

Resco  Marine  Corps  Shoe  Fitting  System 83 

Procedure  in  Measuring  the  Foot 85 

Verifying  the  Size  and  Fitting  the  Shoe 87 

Measuring  and  Fitting  at  the  Barracks  (3000  Men  and.Over)..    .  93 

The  Fitting  Quarters 93 

General  Procedure  of  Fitting 98 

Measuring  and  Fitting  Men  at  the  Barracks  or  in  the  Field 

(500-3000  Men) loi 

The  Fitting  Quarters 101 

Measuring  and  Fitting  Men  in  the  Field  (500  Men  or  Less)    .  107 

Appendix in 

Old  Army  Order  Covering  the  Subject  of  Foot  Measuring  and 

Shoe  Fitting in 

New  Army  Orders 116 

Text  of  Revised  Regulations  Applying  to  the  Fit  of  Enlisted 

Men's  Shoes • 116 

Marine  Corps  Orders 122 

Post  Special  Order  No.  47 123 


FOOT  CARE 
AND   SHOE   FITTING 


VALUE  OF  THE  PROPER  FOOT  CARE 

Mobility  is  the  first  requisite  of  the  soldier  and  to  insure  this 
the  infantry  officer  should  devote  as  much  attention  to  the  care 
of  the  feet  of  the  men  of  his  unit  as  the  cavalry  officer  devotes 
to  the  care  of  the  feet  of  his  horses.  This,  however,  is  not 
always  the  case. 

The  European  authorities  allow,  when  unseasoned  troops 
take  the  field,  for  lo  per  cent,  of  incapacitation  through  pre- 
ventable foot  injuries.  This  is  almost  equal  to  the  casualties 
following  an  engagement  with  the  enemy.  More  emphatically 
expressed;  should  a  "million  citizens  spring  to  arms  over  night," 
there  is'every  reason  to  expect  100,000  of  them  to  be  on  the  sick- 
list,  because  of  foot  disorders. 

According  to  Napoleon's  dictum,  "more  battles  are  won  by 
strength  of  leg  than  b}'  force  of  anns."  The  military  .successes 
of  Stonewall  Jackson  have  Ijecn  attributed  largely  to  the 
marching  capacity  of  his  command,  which  officer  is  quoted  as 
saying  that  he  had  rather  lose  two  men  in  battle  than?  one- 
man  in  marching. 

Another  military  leader  believes  that  battles  are  won  jiKjrc 
by  "sweat  tlian  slaughter."  Ac:f:ording  lo  Wellington  "the 
most  essential  juirt  of  a  soldier's  ccjuiiniient  is  a  good  jxiir  of 


2  FOOT   CARE   AND    SHOE   FITTING 

shoes,  and — ,  another  good  pair  of  shoes."  Another  military 
leader  is  quoted  saying  that ' '  getting  there  first  with  the  most 
won  battles." 

In  the  Franco-Prussian  War,  over  thirty  thousand  German 
soldiers  were  incapacitated  in  the  first  few  weeks  on  account 
of  preventable  injuries  to  the  feet. 

"The  army  which  marches  best,  other  things  being  equal, 
is  the  successful  army."     (Munson.) 

ORTHOPEDIC  ORGANIZATION 

(a)  Orthopedic  Surgeon. 

It  has  been  the  custom  of  this  Post  to  designate  one  of 
the  medical  officers  as  orthopedic  surgeon;  who,  in  addition 
to  his  other  duties,  is  responsible  for  formulating  the  neces- 
sary rules  and  regulations  on  foot  care  and  shoe  fitting. 

Two  of  the  overseas  regiments,  leaving  this  Post,  had  a 
medical  officer  who  had  received  some  instruction  on  this 
subject,  and  acted  in  this  capacity. 

In  any  organization,  unit,  or  detachment,  it  appears  advis- 
able to  assign  one  medical  officer  to  this  duty,  preferably  one 
who  is  interested  in  this  subject. 
(6)  Foot  Inspectors. 

From  all  reports,  the  foot  inspectors  have  rendered  very 
valuable  assistance,  during  the  recent  w^ar.  These  men  were  of 
two  classes.  One  class  was  composed  of  Marines,  who  had 
enlisted  for  this  class  of  duty,  which  duty  they  performed  under 
the  supervision  of  the  medical  department.  Another  class 
were  men  of  the  hospital  corps  who  had  previous  instruction 
or  training  along  this  line. 

There  should  be  one  inspector  for  each  thousand  men  when 
they  take  the  field.  The  orthopedic  surgeon  should  be  pre- 
pared to  instruct  and  train  such  members  of  the  hospital 
corps  as  may  be  deemed  necessary  for  this  work. 


THE    MARCH  3 

RESPONSIBILITY  FOR  PROPER  FITTING  OF 
SHOES 

This  appears  to  be  a  case  of  divided  responsibility,  accord- 
ing to  Marine  Corps  Orders  No.  185,  (4)  and  1S5,  (5)  (Series 
1 916),  the  responsibihty  rests  largely  with  the  company 
commander. 

The  situation  is  analogous  to  sanitation.  The  regulation 
requires  the  commanding  officer  to  be  responsible  for  the  sani- 
tary condition  of  his  station,  yet  requires  the  medical  officers 
to  take  the  initiative  in  making  necessary  recommendations. 

Although  there  is  nothing  explicit  in  the  Regulations  on  this 
subject,  it  is  well  to  assume  that,  on  account  of  certain  tech- 
nical matters  involved,  the  medical  de])artment  should  act  in 
the  advisory  capacity',  and  take  the  initiative  whenever  the 
occasion  arises.  This  is  in  accord  with  oin-  ex])crit'nccs  at  this 
Post  (Quantico,  Va). 

THE  MARCH 

Man^hin;^  i.s  usually  a  military  ncrcs.sii\-  executed  to  bring 
troops  into  advantageous  or  strategic  positions  at  or  near  the 
battle  line.  It  is  therefore  necessary  to  take  well-known  pre- 
cautions in  order  that  the  men  may  arrive  at  their  de.stination 
in  the  Ijcst  physical  condition  and  not  comijlctely  fatigued. 
The  starting  hour  is,  of  course,  determined  by  the  existing 
necessities.  Whenever  possible,  however,  it  should  be  in  the 
early  morning  when  the  men  arc  fresh  and  active  and  the  air  is 
cool  and  stimulating.  Unless  unavoidable,  strenuous  march- 
ing during  the  heat  of  the  <lay  should  not  be  attempted. 
Night  marching  should  be  i>ractiscd  only  when  military 
necessity  demands,  because  the  depressing  jjhysical  effects 
usually  outweight  the  advantage  of  strategic  positions. 

Previous  to  the  start  a  light  meal  of  bread,  cereals,  milk, 


4  FOOT   CARE   AND    SHOE   FITTING 

tea,  or  coffee  should  be  allowed.  Marching  with  empty 
stomachs  is  weakeninj^  and  therefore  detrimental. 

The  length  of  the  march  for  a  division  or  a  brigade  under 
normal  conditions  should  not  exceed  12  or  15  miles  daily. 
The  length  of  a  day's  march,  however,  is  not  measured  by 
miles,  but  according  to  the  condition  of  the  roads,  the  weather, 
the  pace,  the  loads  carried,  etc. 

The  rate  of  the  march  should  not  average  more  than  2^^ 
miles  per  hour,  inclusive  of  stops;  more  than  this  will  lead  to 
fatigue  and  exhaustion.  To  average  this,  120  30-inch  steps 
a  minute  are  required.  The  march  should  be  at  route  order, 
in  open  ranks,  half  on, each  side  of  the  road.  This  decreases 
the  heavy,  devitalizing  cloud  of  dust,  foul  odors,  water  vapor 
from  perspiration,  etc.,  which  tends  to  hang  over  close-order 
ranks.  The  march  should  end  with  the  same  equal  pace  with 
which  it  started;  the  frequent  "final  spurt"  should  not  be 
invoked  as,  at  this  stage,  it  is  doubly  depressing.  The  men 
should  alternate  between  marching  in  step  and  at  ease;  singing 
and  w^histling  popular  tunes  is  to  be  encouraged.  This  dis- 
tracts their  minds- from  their  fatigued  condition,  and  is  probably 
the  surest  way  of  preventing  early  exhaustion.  Straggling, 
either  from  poor  discipline  or  fatigue,  is  always  to  be  avoided, 
as  it  is  depressing  to  the  "morale"  of  the  entire  body  of  troops. 

In  hot  weather  coats  should  be  unbuttoned  or  removed  on 
the  march  but  replaced  at  halts.  The  position  of  the  body 
should  be  inclined  slightly  forward,  similar  to  the  position  in 
mounting  a  flight  of  stairs.  This  is  especially  to  be  advised 
if  the  soldier  is  carrying  his  full  equipment.  Marching  rigidly 
erect  necessitates  the  expending  of  greater  muscular  effort 
and  therefore  early  fatigue. 

Smoking  on  the  march  has  a  depressing  effect  on  the  physical 
condition  of  the  men,  particularly  upon  the  heart  and  lungs. 
It  also  had  a  tendency  to  cause  the  mouth  to  become  dry, 


THE    MARCH  5 

creating  excessive  thirst.  This  practice  should  be  strictly 
prohibited. 

Before  the  start  only  the  average  amount  of  water  to  a  meal 
should  be  ingested  and  the  water  bottles  filled  with  water, 
unsweetened  tea.  or  coffee.  Following  this,  the  canteens 
shiould  not  be  resorted  to  until  732  niiles  have  been  covered. 
The  contents  should  then  take  the  men  to  the  end  of  the  15- 
mile  march.  The  bottle  should  again  be  refilled  at  the  end  of 
every  subsequent  mile.  The  average  normal  requirements 
are  one  quart  of  water  at  the  end  of  ever\-  7 '  2  miles. 

The  experienced  soldier  will  march  nearly  all  day  with  only 
an  occasional  recourse  to  his  water  bottle,  and  then  drink 
\'er\'  sparingly.  The  young  and  unwise  will  drink  excessively 
every  few  miles,  and  as  a  consequence  becomes  "water- 
logged," perspires  freely,  tires  easily,  and  refills  his  bottle 
from  every  strange,  perhaps  heavily  contaminated,  stream 
along  the  wayside.  Water  bottles  should  not  be  filled  at 
these  streams  until  the  quality  of  the  water  is  a])i)rovcd  by 
the  medical  officer. 

A  fairly  satisfactory  method  of  allaying  the  thirst  while 
on  the  march  is  to  suck  on  a  small  pebble  placed  in  the  mouth, 
to  excite  the  flow  of  saliva,  at  the  same  time  breathing  through 
the  nose. 

A  few  words  on  flexion,  or  bent  knee  marching  might  not  be 
out  of  place.  This  is  a  method  advocated  by  dc  Raoul  and  is 
patterned  after  the  oriental  couriers  and  footmen.  In  this 
type  of  marching  the  body  is  bent  forward  at  the  hips,  and 
the  legs  are  bent  at  the  knees,  in  .such  a  manner  that  it  gives 
the  marching  man  the  attitude  of  almost  falling  forward  at 
each  stej).  The  displacement  of  the  center  of  gravity  of  the 
body  forward  serves  automatically  at  each  step  to  drag  the 
weight  of  the  body  along. 

Unless  this  method  is  thoroughly  understood,  and  is  system- 


6  FOOT   CARE    AND    SHOE   FITTING 

atically  developed,  any  attempt  to  change  the  method  of 
marching,  which  each  soldier  has  developed  as  his  peculiar, 
individual  type,  may  not  be  productive  of  the  best  results. 

To  Lieutenant  S.  A.  Folsom,  MC,  U.  S.  Navy,  is  acknowledged 
credit  of  the  preparation  of  the  major  portion  of  the  following 
chapters. 

TENDENCY  TO  PROCURE  A  SMALLER  SHOE 
THAN  NECESSARY 

For  some  reason  there  appears  to  be  a  tendency  inherent 
in  the  human  race  to  procure  a  casing  for  the  foot  which  is  too 
small. 

As  an  extreme  example,  illustrative  of  this  fact,  it  may  be 
mentioned  that  the  gro\\i:h  of  the  foot  of  the  Chinese  gentle- 
woman is  stunted  froin  infancy  by  tight  coverings.  This 
trait  is  again  illustrated  by  the  modern  woman  wearing  a  tight 
shoe,  with  a  short  vamp  and  a  high  heel,  causing  the  foot  to 
be  extended,  which  gives  it  an  appearance  of  brevit^^  The 
male  members  do  not  escape  this  tendency,  not  even  in  a 
military  organization.  An  examination  of  several  thousand 
men  on  this  station  reveals  that  about  80  per  cent,  were 
wearing  shoes  which  were  too  short. 

The  public  is  apparently  awakening  to  this  error,  judging 
from  the  number  of  advertisements  of  the  so-called  orthopedic 
shoe,  appearing  in  the  current  magazines,  and  are  endeavoring 
to  correct  the  same.  However,  the  faults  of  a  lifetime  cannot 
be  remedied  in  a  day  or  a  week  but  requires  the  wearing  out  of 
at  least  one  pair  of  properly  fitted  shoes  before  satisfactory 
results  may  be  expected. 
Conditions  Afloat. 

While  the  material  in  this  book  may  be  considered  of  pri- 
mary importance  to -the  Marine  Corps  on  expeditionary  duty 


ANATOMY   AND    PHYSIOLOGY  7 

yet  there  may  be  nixmerous  occasions  where  these  remarks  are 
equally  applicable  to  officers  and  men  of  the  Na\'^'. 

In  naval  training  stations  and  where  members  of  the  navy 
form  landing  parties,  the  necessity  of  properly  shod  feet  is 
obvious. 

Aboard  ship,  in  the  period  of  the  four  hour  watch,  officers 
and  men  often  cover  rather  long  distances  in  walking  to  and  fro 
on  the  hard  decks.  But  on  occasions  like  this  the  feet  support 
only  the  weight  of  the  body  and  there  are  no  heavy  impedi- 
ments to  cause  an  exaggeration  of  any  minor  defects  of  the 
foot  gear.  This  fa\'orablc  condition  is,  however,  partly 
offset  by  the  fact  that  there  is  little  resiliency  to  a  steel  or 
wooden  deck  as  is  apt  to  be  present  when  a  command  is 
marching  on  land. 

All  things  considered,  improperly  litted  shoes  may  not  result 
in  as  large  a  percentage  of  foot  injuries  among  those  afloat  as 
in  an  infantr}'  organization,  yet  such  defects  may  result  in 
certain  postural  abnormalities  which  may  produce  certain  well 
defined  constitutional  symptoms. 

ANATOMY  AND  PHYSIOLOGY  OF  THE  FOOT 

The  human  loot,  considered  in  its  entirety,  is  indeed  a  very 
wonderful  anatomic  part  of  the  individual.  In  the  smallncss 
of  its  size  and  weight,  out  of  all  proportion  U)  the  burden 
borne  and  carried,  it  constitutes  a  mobile,  strong,  flexible  and 
efficient  member  of  the  organism  designed  to  bear  weight 
forwards,  backwards,  and  sideways  without  mishap.  Encased 
in  a  cloth  covering,  the  sock,  and  in  a  protective  leather  cover- 
ing, the  shoe,  both  concomitants  of  an  advancing  and  exacting 
'  ivilization,  this  member,  the  most  unintentionally  neglected 
l^art  of  the  body  is  fully  expected  to  do  its  duty  indefinitely 
without  complaint.     As  with  other  mccliani.sms,  mechanical 


8 


FOOT    CARK    AND    SHOE    FITTING 


or  otherwise,  so  with  this,  ignorance  cannot  accomplish  satis- 
factory results. 


'calcaneus  (OS  CALCIS.)  HEEL  BONE^. 


STATIC  PORTION 
OF  THE  FOOT. 
SEVEN  BONES 


DYNAMIC  PORTION 
OF  THE  FOOT. 
NINETEEN  BONES 


SURFACE  OF  TALUS  (ASTRAGALUS) 
FOR  ARTICULATION  WITH  TIBIA 
(LOWER  LEG  BONE) 

CUBOID 

NAVICULAR  (SCAPHOID) 

.THIRD    ) 

, SECOND  ^CUNEIFORMS 
FIRST    J 


METATARSALS 


PHALANGES  (TOES.) 


Fig.   I. — Skeleton  of  right  foot  from  above.      [Cunningham.)     Dotted  line 
shows  anterior  arch  formed  by  metatarsal  bones. 

Concisely,  the  structure  of  the  foot  is  composed  of  a  nicely 
adjusted  aggregation  of  twenty-six  bones  of  various  sizes  and 


ANATOMY    AM)    PHYSIOI.CK'.Y  Q 

shapes,  each,  however,  designed  to  perform  a  certain  definite 
lunction.  Seven  of  these  are  of  a  very  irregular  shape  and  are 
located  in  the  hind  part  of  the  structure  fonning  the  heel  and  a 
portion  of  the  so-called  instep.  The  remaining  nineteen,  situ- 
ated in  the  forepart  of  the  foot,  form  a  portion  of  and  radiate 
fan-like  from  the  instep.  These  extend  forward  and  to  the 
luter  and  inner  sides  finally  ending  in, the  toes.  (See  illus- 
iration  No.  i.)  These  different  bones  are  held  in  the  correct 
position  by  ligaments,  tendons  and  muscles;  the  ligamentous 
support  predominating  in  the  posterior  seven  bones  which 
form  the  static  portion  of  the  foot  while  muscular  action  pre- 
dominates in  the  anterior  nineteen  bones  which  fonn  the 
dynamic  portion.  (See  illustration  No.  i .)  Over  the  dorsum 
')r  ujjper  surface  of  the  foot  the  muscles  are  few  in  number 
md  lacking  in  development.  However,  on  the  plantar  or 
lower  surface  filling  in  the  arch  beneath  the  instep  there  are 
five  la\'ers  of  well-develojjed  muscles  which  buttress  the  arch 
preventing  descent  of  the  latter  when  continued  and  excessive 
weight  is  borne.     (See  illustration  No.  2.) 

The  posterior  seven  bones,  forming  a  compact  mass  and 
held  h)y  ligamentous  attachments,  move  very  slightly  when  a 
step  is  taken  and  serve  to  minimize  the  shock  of  impact  and 
act  as  a  recoil  mechanism.  On  this  mass — the  static  portion 
of  the  foot — in  the  shod  man,  all  the  weight  of  locomotion  is 
first  borne;  first  affecting  the  heel  and  center  of  the  instcji. 

The  anterior  nineteen  bones  are  controlled  mainly  by 
muscular  action — the  dynamic  jjortion — and  when  in  use 
bearing  weight,  move  extensively.  From  the  center  of  the 
instep  the  weight  borne  is  shifted  to  the  ball  of  the  iooi  which 
preads  medially  and  laterally  presenting  an  enlarged  area  to 
the  walking  medium.  The  toes  also  spread  laterally,  medially, 
and  lengthen,  gri])ping  the  surface.  (Sec  illustrations  Nos.  3 
and  4.) 


lO 


FOOT   CARE    AND    SHOE    FITTING 


y?  a  X  •" 

•;^    -e>    -^     CJ 


^    O  »b 


•-■  a  o 


-  t;  r;  5 


O    H 


11    ^^ 


CC 


o    t£ 


43  -a 


O    d    ?i 


SE 


ANATOMY   AND    PHYSIOLOGY  II 

The  longitudinal  arch,  on  the  inner  side  of  the  foot  extends 
from  the  heel  bone  (Os  Calcis)  to  the  distal  end  of  the  first 


1  i(..     <.      Muscles    con-  Ik..    .|.      J>ii).    lu.i-.  ..^  ..i  Iik.I.       Muscles 

trfilliriK    lateral    toe  action.        and   tendons  controllinK  toe  action.      (C«m- 
I  Cunningham.)  niti/^ham.) 

metatarsal  bone.     (See  illustration  No.  2.)     This  is  definitely 
fonncd  by  the  inherent  structural  concavity  of  the  bones  held 


12 


roor    (,AKF.    AX])    SIIOK    FITTIXC, 


among  themselves  by  ligaments  and  supported  from  below  by 
developed  muscle  layers. 

The  anterior  arch  is  formed  by  the  distal  ends  of  the  meta- 
tarsal bones.  (See  illustration  No.  5.)  Themuscular  develop- 
ment concerned  in  sustaining  this  arch  is  not  so  great  as  in  the 
longitudinal. 


Fig.   5. — Cross  section  of  feet  showing  metatarsal  bones  forming  anterior 

arch. 

A  shows  formation  of  anterior  arch  by  dit.tal  ends  of  metatarsal  bones. 
Xote  convexity  of  instep,  dotted  line  indicating  integrity  of  arch  and  con- 
cavity formed  on  the  plane  C. 

B  shows  fallen  anterior  arch.  Xote  flat  or  convex  instep,  dotted  line  and 
absence  of  concavity  on  the  plane  C. 

A  tripod  is  formed  by  the  structure  of  the  foot;  the  apex  of 
which  is  the  highest  point  of  the  heel  bone  (Os  Calcis),  the 
inner  side  of  the  ball  of  the  foot  at  the  base  of  the  big  toe 
(distal  end  of  first  metatarsal  bone)  and  the  outer  side  of  the 
ball  of  the  foot  at  the  base  of  the  little  toe  (distal  end  of  the 
fifth  metatarsal  bone).     (See  illustration  No.  6.) 

A  comparison  of  the  feet  of  the  shod  man  and  the  bare 
footed  savage  is  interesting  and  instructive.  In  the  shod  man 
the  joints  are  not  as  flexible,  the  muscles  are  not  as  well 
developed  and  the  toes  in  walking  do  not  spread  and  grip; 
being  limited  by  the  shoe.     Taking  a  step  he  strikes  the  heel 


ANATOMY    AND    PHYSHn.OGY 


13 


Pic;.   6.    -Anterior  view  of  feci  and  legs  bhcjwinn  inpod  formation,  correct 
foot  posture  and  position  of  normal  ankles. 


14  FOOT   CARE    AND    SHOE    FITTING 

first,  shifts  the  weight  to  the  outer  border  of  the  foot,  then 
full  upon  the  ball  while  the  toes  as  above  explained,  are  limited 
in  their  motion.  In  that  the  shoes  limit  the  bearing  surface 
of  his  feet  he  "toes  out"  sometimes  sHghtl}^  other  times 
excessiveh',  to  preserve  his  equilibrium,  thus  throwing  the 
weight  borne  backward  on  the  inner  border  of  the  foot — on 
the  arch — where  it  should  not  all  be  borne.  (See  illustration 
No.  9.) 

On  the  other  hand,  the  savage  has  very  flexible  joints,  well 
developed  muscles  under  the  arch  as  are  also  the  muscles  of 
the  calf  of  the  leg.  In  locomotion  he  has  his  feet  parallel — the 
correct  postiu-e — or  "toes  in"  throwing  the  weight  upon  the 
ball  of  the  foot,  center  of  the  instep  and  outer  border  of  the 
foot.  His  toes  unhampered  by  a  covering  spread  widely, 
lengthen,  grip  the  surface,  and  thrust  vigorously  backwards. 
He  walks  on  soft,  nonresistant  earth  which  conforms  itself  to 
the  irregularities  of  the  foot  forming  an  accurate  impression 
which  lessens  the  strain  on  the  muscles  and  ligaments  and 
minimizes  the  shock  of  impact.  The  reverse  is  true  in  the 
civilized  individual  who,  his  feet  encased  and  limited  in  motion 
by  a  covering  the  bottom  of  which  does  not  conform  to  the 
irregularities  of  the  foot,  walks  the  greater  part  of  his  life  on 
macadamized  roads  or  rock  pavements  where  muscle  strain 
and  shock  of  impact  is  great. 

DEVELOPING  THE  FEET  OF  TH.E  RECRUIT 

Upon  the  physiological  development  and  muscular  efficiency 
of  the  recruit's  feet  depends  largely  his  future  usefulness  as  a 
soldier.  He  is  made  or  broken  in  the  training  camp.  Com- 
parisons are  helpful  in  explaining  a  delicate  situation.  Just 
as  the  professional  weight  lifter  can  not  and  does  not  develop 
his  enormous  muscles  in  a  night  or  day,  so  it  is  with  the  foot 


DEVELOPING    THE    FEET 


15 


muscles  of  the  new  arrival  in  canip.     The  truth  is,  we  have 
expected  too  much  of  the  recruit  and  ha\'e  done  too  little  to 


I  i' 


f'orrcct  f'lol  pnstiiri 


help  him.     The  ^reat  majority  of  men  come  from  sedentary 
occupations  in  civilian  life  and  enter  upon  an  active  pcdestrial 


i6 


KOOT    (AKK    AXl)    SIIOF.    FITTING 


life,  when  they  enter  the  vservice;  and  we  must  realize  their 
short-comings  and  strive  to  develop  these  men  correctly  if 
iTood  results  are  to  be  accomplished.     The  greater  part  of  the 


w 

l^^^^^BRH 

'^^^^^^^^^^ipH^M^ 

It         "*'    r' 

'  *'  ^^^K^ 

1 

>:  *'^^^^^^^^H 

-A 

^^ 

^^3\1. 

-iit-^ 

Fig.   8. — Incorrect  foot  posture.     "  Toeing  in."     Pigeon  toed. 


responsibility  of  developing  this  raw  material  depends  primarily 
and  essentially  on  the  line  officer,  who,  if  he  is  to  turn  out 
the  largest  nimiber  of  fighting  units,  must  know  this  subject 
and  apply  it  in  practice.     That  failure  has  often  played  a 


DEVELOPING    THE    FEET  17 

great  part  is  evidenced  by  the  numerous  examples  of  men 
disabled  by  foot  trouble  on  the  sick-list  and  awaiting  surve>-. 
These  men  represent  a  loss  of  time  and  money  to  the  govern- 
ment and  are  deadweights  and  incumbrances  to  the  efficiency 
of  the  militarv  machine. 


Pir;.  9. —  Incorrect  foot  posture.     Military  position.     "Toi-iriK  out." 

When  the  recruit  is  first  received  in  the  service,  careful 
and  accurate  measurements  should  be  made  of  the  feet,  sock 
sizes  estimated  and  shoes  fitted.  The  work  done  in  these  for- 
mative periods  must  be  graduated;  that  is,  the  distances 
marched  or  hiked  and  equipment  borne  nnist  be  gradualh- 
increased. 


1 8  FOOT   CARE   AND    SHOE   FITTING 

This  is  done  to  develop  the  muscles  of  the  feet,  especially 
under  the  arch  in  the  sole  of  the  foot,  and  is  left  to  the  dis- 
cretion of  the  officer  in  charge,  advised  by  the  surgeon. 

At  the  end  of  about  three  months  the  feet  should  be  re- 
measured,  sock  sizes  re-estimated  and  shoes  refitted.  Why? 
Because  the  muscles  of  the  feet  have  developed  and  the  feet 
are  thicker,  broader  and  longer,  so  that  the  previous  procedure 
does  not  suffice.  After  this  second  measurement  and  fitting, 
the  same  size  shoe  and  sock  ma^^  be  worn  as  long  as  the  indi- 
vidual is  in  the  service;  exceptional  instances  requiring  a  third 
measiu"ement  and  fitting  which  should  be  done  if  complaint  is 
made. 

ANATOMY  OF  THE  SHOE 

To  know  a  shoe  and  to  appreciate  fully  it's  construction 
internally  and  externally  one  must  necessarily  know  the  names 
of  the  different  parts.  The  parts  of  the  shoe,  externally 
from  being  forward  are:  the  lifts  of  the  heel,  face  of  the  heel, 
breast  of  the  heel,  waist  or  shank,  sole,  welt,  vamp  and  upper. 
(See  illustration  lo.) 

The  best  way  to  study  the  internal  construction  of  a  shoe 
is  by  a  cross-section.  In  a  cross-section  the  following  parts 
of  the  shoe  are- to  be  seen;  the  sole,  welt,  thread  holding  the 
welt,  upper  and  insole  together  (Goodyear  Welt),  drill  lining 
and  vamp  of  the  upper.  (See  illustration  ii.)-  There  are 
four  standard  types  of  internal  shoe  construction.  They 
are  the  following: 

1.  Goodyear  welt. 

2.  McKay  sewed. 

3 .  Standard  screw. 

4.  Pegged. 


ANATOMY   OF    THE    SHOE 


19 


20 


FOOr    t'ARE    AND    SIIOK    I'lTlKNG 


Of  these  four  types  the  Goodyear  Welt  is  the  most  widely  used 
and  universally  adopted  shoe.  In  maniifacturing  the  Good- 
\'ear  Welt  shoe  the  tacks  in  the  lasting  are  all  withdrawn  and 
a  machine  with  a  curved  needle  sews  the  welt  and  upper  to  the 
insole  without  entering  the  shoe  cavity.  The  heavy  outsole 
is  then  stitched  to  the  welt.     (See  illustration. y 


Fig.    II. — Goodyear  welt  shoe.      Cross  section.      Sole,   welt,   insole  and  fill 


A  =  Sole. 
B  =  Welt. 
C    =  Insole. 


exaggerated. 

D    =  Pill. 
E    =  Vamp. 
F    =  Drill  lining. 
Thread  (Goodyear  welt  feature). 


This  type  is  superior  in  its  construction  to  all  others  for  the 
following  reasons : 

1.  Smooth  surface  inside. 

2.  Most  durable,  efficient  and  comfortable  shoe. 

3.  Outsole  can  easily  be  renewed. 


CARE  OF  THE  SHOES 

Badly  Fitting  Shoes. 

Where  the  shoe  is  either  too  large,  too  small,  or  too  old 
with  wrinkled  and  broken  drill  lining  there  inevitably  results 


CARE    OF    THE    SHOES  21 

friction,  pressure  and  impact.  These  three  factors  are  para- 
mount in  the  causation  of  callosities,  corns,  blisters,  abrasions, 
tender  and  sore  feet.  So,  in  the  examination  of  a  shoe  search- 
ing for  the  causative  agent  of  foot  disability,  the  fact  that  the 
shoe  may  be  too  large,  too  small,  or  too  old,  should  be  borne 
in  mind.  The  part  that  the  socks  play  will  be  discussed  under 
that  heading. 

Where  the  injuries  above  enumerated  occur  the  shoe  should 
be  examined  thoroughly  for  the  points  mentioned: 

1.  Top  of  toes — toe  cap  too  low,  leather  stiff,  improper 
construction ; 

2.  Ends  of  toes — shoe  too  short,  loosely  laced,  improper 
construction ; 

3.  Outer  sides  of  big  and  little  toes — shoe  too  narrow  across 
the  instep. 

4.  Over  the  instep — tightly  laced  shoes,  uneven  wrinkled 
tongue; 

5 .  Along  the  outer  and  inner  margins  of  the  sole  of  the  feet — 
faulty  internal  construction  resulting  in  thick  inner  edge  of 
insole  or  warping  or  curling  of  the  latter. 

6.  On  the  sole  of  the  feet — inequalities  o(  the  inner  sole 
caused  by  the  warping  of  the  leather  or  shifting  of  the  fill 
(layer  below  the  insole.) 

The  shoes  being  the  most  imjjorlanl  \)url  of  the  soldier's 
equipment  and  the  back  bone  of  an  infantry  organization's 
efficiency;  it  is  essential  and  imjjcrative  that  an  elementary 
knowledge,  at  least,  of  their  care  be  part  of  the  officers  knowl- 
edge. This  knowledge  should  be  imparted  to  the  men  at  each 
and  every  (jpjjortunity  where  the  occasion  offers  itself. 

To  make  the  foot  covering  as  water-proof  as  possible  undir 
ordinary  conditions  the  sole  and  welt  should  be  thoroughly 
oiled  with  neatsfoot  oil,  bacon  rind  (salt  removed  by  s«)aking) 
or  in  emergencies  with  machine  oil  of  good  quality  as  used  in 


22  rOOT    CARE    AND    SHOE    FITIIXG 

the  lubrication  of  the  rifle.  Where  constant  exposure  to 
water  and  cold  is  anticipated  the  upper  as  well  should  be 
thoroughly  oiled  by  application  of  the  oil  and  rubbing  and 
kneading  of  the  leather.  Judgment,  however,  should  be 
practised  in  oiling  the  uppers  because  too  much  oil  is  a  detri- 
ment, in  that  it  clogs  the  pores  of  the  leather  making  the 
latter  impermeable  and  preventing  the  moisture  of  the  foot 
from  evaporating.  This  condition  of  the  shoe,  then,  is  com- 
parable to  rubber  which  is  also  impermeable. 

Where  the  shoes  have  become  water  soaked  from  continued 
wetting  do  not  place  them  too  near  a  fire  as  such  quick  drying 
causes  stiffness  and  hardness  of  the  leather  with  the  j^roduction 
of  corns,  blisters,  abrasions  and  similar  affections.  From  the 
action  of  rapid  drying,  also,  it  should  be  noted  that  the  leather 
decomposes  and  disintegrates  quickly  lessening  the  life  of  the 
shoe.  Where  haste  is  necessary  pebbles  ma}^  be  heated  and 
repeatedly  placed  in  the  shoe  and  agitated  until  a  sufficient 
degree  of  dryness  has  been  obtained.  Hot  cloths  may  be 
placed  in  the  shoe  or  oats  which  absorb  moisture  readily. 
The  shoes  being  dried  by  what  ever  method  chosen,  the}"  should 
be  thoroughly  brushed  and  the  leather  kneeded  with  the 
fingers  until  supple.  Wet  shoes  should  never  be  exposed  to 
the  elements  in  freezing  weather  as  the  leather  will  become 
frozen.  Should  the  shoes  issued  be  lined  with  drill  ducking 
this  should  be  examined  frequently  to  see  if  it  is  torn,  wrinkled 
or  lying  smoothh^  in  the  shoe  cavit}'.  Dress  shoes  used  for 
liberty  should  be  kept  brushed  and  polished  constantly  if  long 
life  is  to  be  expected  of  the  leather. 

As  a  preventive  measure  troops  should  be  urged  to  examine 
the  shoe  cavity  for  protruding  nails,  wrinkles  of  leather  or  drill 
ducking  and  other  inequalities  of  the  surface.  Broad  laces 
should  be  used  and  laced  stifficiently  for  the  march  to  hold  the 
heel  in  place  and  jirevent  shifting  of  the  foot  forward  in  the 


SHOE-FITTING  21, 

shoe.     The  tongue  of  the  shoe  should  be  smooth,   free  of 
wrinkles  and  lie  evenly  under  the  laces. 

SHOE-FITTING 

Fitting  and  Care  of  Socks. 

The  practical  importance  of  correctly  litting  socks  to  the 
infantryman  can  hardly  be  justly  estimated  as  no  matter  how- 
much  care  and  judgment  is  exercised  in  fitting  shoes  all  this 
work  is  for  naught  if  the  cloth  foot  covering  is  too  large  or  too 
small.  The  inevitable  conclusion  is  thus  reached,  that  a  sock 
too  loose  or  tight  in  a  correctly  fitting  shoe  does  as  much 
damage  and  incapacitates  the  individual  as  much  as  a  poorly 
fitting  shoe. 

The  way  to  the  ideal  system  of  fitting  sock  sizes  to  the 
corresponding  shoe  sizes  is  partially  obstructed  by  obstacles 
which  must  be  overcome  if  complete  success  is  to  be  attained. 
Ii)ssentially,  these  obstacles  to  our  i)rogress  consist  of  various 
lifferences  which  exist  in  socks  of  the  same  weight,  size  and 
material;  namely,  flexibility  and  shrinkability.  This  is 
a]jplicaljle  to  both  wo(jlen  and  cotton  socks.  Further,  there 
is  to  be  considered  the  multiple  variations  in  the  relative 
length,  width  and  shape  of  the  feet.  Although  it  is  readilx- 
conceivable  that  a  sock  of  elastic  material  will  be  conformed 
: ')  the  shape  of  the  foot,  yet  there  is  to  be  considered  the  fact 
that  the  difTerent  materials  after  relocated  washings  will  ni)i 
sometimes  do  this.  An  ideal  material  whose  definite  elasticity 
and  shrinkability  is  predetermined  accurately,  and  reservations 
made  for  variations,  will  do  much  toward  establishing  some 
fundamental  plan  for  litting  socks  accurately. 

At  the  present  time  a  general  i)lan  consisting  of  a  "Sock 
Size  Scale"  which  corres])onds  to  difTerent  shoe  sizes  has  been 
adopted  to  remedy  as  much  as  possible  the  existing  evil  of 


24  FOOT   CARE   AND    SHOE    FITTING 

ill-fitting  socks.     This  scale  can   be  readily  understood  by 
reference  to  the  plate  in  this  Chapter. 

Shoe  Size  Corresponding 

Sock  Size 

5 


5M 
6 

6}4\ loK 

7 

73^ 

8 

9 

gVz} "K 

lO 

II 

12 

123^  \ 12H 

13 

14  !• 13 

14M. 

15  [ 13M 

Acutely  realizing  the  present  situation,  and  endeavoring 
to  obtain  some  definite  information  as  to  the  degree  of  varia- 
tion in  socks  of  the  same  weight,  size  and  material  after  re- 
peated washings  a  series  of  experiments  were  conducted  at 
this  Post  (Quantico,  Virginia).  Standard  Marine  Corps 
socks  (size  11)  of  Heavy  Woolen,  Light  Woolen  and  Black 
Cotton  were  used. 

These  experiments  were  made  to  determine : 

I.  The  amount  of  shrinkage  in  cotton  and  woolen  socks; 


SHOE-FITTING  25 

2 .  The  amount  of  flexibility  lost  in  cotton  and  woolen  socks ; 

3.  The  effect  of  temperature  on  the  amount  of  shrinkaj^e 
and  loss  of  flexibility  in  cotton  and  woolen  socks. 

The  material  of  the  socks  used  was  as  follows : 

1.  Heavy  woolen.  Yam.  Gray  worsted,  made  from  not 
less  than  pure  ^i  blood  wool ; 

2.  Light  woolen.  Yam.  White.  Commercially  known  as 
merino,  composed  of  50  per  cent,  wool  and  50  per  cent,  cotton. 

3.  Cotton.  Yarn.  Black.  Uniform  quality  of  yarn,  best 
"peeler"  or  equally  long  staple  cotton  free  from  impurities 
and  full  combed. 

Tests  were  as  follows  : 

Heavy  woolen,  light  woolen  and  cotton  socks  each  washed 
three  times  at  same  temperature.  Three  temperatures  were 
used  212,  200,  and  75  degrees  Fahrenheit  respectively.  Ivory 
soap  was  used. 

The  greatest  amount  of  shrinkability  and  lost  elasticity 
was  found  in  the  Heavy  Woolen  Sock.  After  the  first  wash- 
ing at  212  degrees  Fahrenheit  and  immersion  for  fifteen  min- 
utes, shrinkage  of  one  inch  in  height,  one  inch  in  width  and  one 
and  and  one-half  inches  in  length  were  noted.  Second  and 
third  washings  at  212  degrees  Fahrenheit  caused  a  further 
shrinkage  one  inch  in  height,  half  inch  in  width  and  half  inch 
in  length.  Total  shrinkage  after  three  washings  at  2 1 2  degrees 
Fahrenheit  as  follows: 

Height  (from  heel  to  top  of  sock  leg) 2     inches 

Width 1.5  inches 

Length .    2     inches 

Total  loss  of  elasticity  noted  as  follows: 

Height  (from  heel  to  top  of  sock  leg) 3      inches 

Width 2      inches 

Length. .  j.5  inches 


26  FOOT    CAKE    AND    SHOE    FITTING 

Washings  and  immersions  in  lcmi)craturcs  of  200  and  75 
degrees  Fahrcnlieit  caused  very  little  shrinkage  and  loss  of 
elasticity.  Boiling  seems  to  play  a  great  part  in  the  produc- 
tion of  shrinkage  and  lost  elasticity. 

In  the  light  woolen  socks  after  three  washings  each  in  the 
different  temperatures  as  given  above  there  was  a  total  shrink- 
age noted  as  follows : 

Height  (from  heel  to  top  of  sock  leg) 0.5  inches 

Width I      inch 

Length 1.2  inches 

Total  loss  of  elasticity  noted  as  follows: 

Height  (from  heel  to  top  of  sock  leg) 1      inch 

Width 1.5  inches 

Length 2.3  inches 

The  total  amount  of  shrinkage  and  lost  elasticity  in  the 
cotton  cocks  after  three- washings  and  immersions  at  each 
temperature  was  very  inconsiderable  and  not  worthy  of  note. 

CARE  OF  SOCKS 

When  being  fitted  for  shoes  the  individual  should  wear  the 
light  woolen  sock  which  is  preferable  for  general  use  about  the 
barracks  and  on  the  march.  In  cold  weather  when  a  heavy 
woolen  sock  is  to  be  worn  larger  shoes  are  necessary  to  pre- 
vent foot  disability.  Socks  that  are  too  small  cramp  the  toes 
and  produce  a  result  identically  the  same  as  pointed  narrow 
shoes.  On  the  other  hand  large  socks  take  up  needed  foot 
space  in  the  shoe;  and  forming  wrinkles  produces  painful 
blisters  and  abrasions. 

On  the  march  every  man  should  carry  at  least  three  extra 
pairs  of  socks.  They  are  a  necessity ;  and  being  light  in  weight 
can  be  easily  carried.     Manifestly,  they  are  a  most  important 


MILITARY    FOOT    INSPFXTION  27 

part  i)i  the  equi^jmeiit.  No  socks  which  have  been  danicd  or 
socks  with  holes  should  be  used  on  the  march.  Imnicdialcl>- 
after  washing  the  feet  the  socks  should  be  washed,  dried  and 
stretched  before  using  again.  Where  facilities  for  washing 
are  not  at-  hand  they  can  be  dried,  kneeded  and  stretched. 
Changing  of  socks  from  one  foot  to  another  is  advisable  where 
time  is  available. 

MILITARY  FOOT  INSPECTION 

The  recent  great  conflict,  despite  the  abundant  means  of 
mechanical  con\-eyances,  has  demonstrated  that  the  days  of 
marching  are  not  over;  and  has  shown  vividly  and  most 
impressively  the  extreme  prevalence  of  minor  foot  ailments 
occurring  not  only  on  the  march,  disabling  and  incapacitating 
many  otherwise  useful  men,  but  also  in  the  barracks  resulting 
from  drill  and  extended  guard  duty.  These  disabled  men, 
often  numerous,  most  assuredly  must  not  all  be  sent  to  the 
Medical  Officer  who  would  be  overcome  by  the  weight  of 
numl:)ers  and  unable  to  gi\-e  each  man  adequate  and  individual 
attention.  Again,  he  would  be  prevented  from  accomj^lishing 
other  important  work  connected  with  the  organization.  The 
Medical  Officer  should  supervise  the  work  of  ])revcnti()n  and 
remedying  of  foot  ailments;  only  attending  j^ersonally  to  tlio 
severe  cases.  To  these  he  can  give  his  undivided  attention 
procuring  quicker  and  better  results  and  thus  lessening  mate- 
rially the  total  number  of  sick  days.  The  urgent  need  of  toda\- 
is  men  trained  in  the  remedying  of  minf)r  foul  ailments  and 
apportioned  to  diff'crent  organizations  according  to  the 
strength  of  the  latter.  Those  interested  in  this  .subject  have 
proposed  that  selected  enlisted  men,  but  i)rcf«rably  hospital 
corpsmen,  with  some  i>revious  medical  experience  be  traine<l 
and  instructed  in  a  school  of  foot  care  at  the  central  training 


28  POOT   CARE   AND    SHOE   FITTING 

l)ost  of  the  Cori:)s;  and  from  here  sent  to  different  minor  posts 
and  organizations  on  duty  in  the  tropics  and  elsewhere.  These 
men,  however,  woidd  perform  their  regular  duties  in  addition 
to  this  special  detail.  Working  under  constant  supervision 
of  a  Medical  Officer  the  work  woidd  be  correctly  done  and 
much  benefit  derived  therefrom. 

TECHNIQUE  OF  TREATING  MINOR  AILMENTS  OF 
THE  FEET 

In  this,  as  in  other  \York  pertaining  to  incision  and  manipula- 
tion of  the  tissues,  scrupulous  care  must  be  taken  that  infection 
does  not  occur.  This  will  not  occur  if  blood  is  not  drawn  and 
cleanliness  and  antisepsis  are  practised  at  all  times. 

Infection  occurring  in  the  feet  because  of  the  attendant 
circumstances  is  often  severe.  This  should  be  especially 
remembered.     The  measures  to  be  taken  consist  of : 

1.  Cleanliness  and  disinfection  of  the  attendant's  hands. 

2.  Cleanliness  and  disinfection  of  the  instruments.  , 

3.  Cleanliness  and  disinfection  of  the  part. 

The  hands  and  foreanns  up  to  and  above  the  elbows  should 
be  thoroughly  scrubbed  with  soap  and  hot  water  where  pro- 
curable and  the  latter  frequently  changed  during  the  process. 
The  brush  should  be  sterile,  made  so  by  boiling.  Special 
attention  in  the  scrubbing  should  be  given  to  the  folds  and 
creases  of  the  skin,  and  to  the  spaces  around  and  beneath  the 
nails.  Rings  should  be  removed  from  the  hands.  Lastly  the 
hands  should  be  scrubbed  in  seventy  per  cent,  alcohol  for  five 
minutes. 

Instruments  should  be  kept  in  case  provided  for  the  purpose 
and  well  covered  with  liquid  petrolatum  or  vaseline  when  not 
in  use  to  prevent  rust.  When  use  is  demanded  wipe  free  of 
oil  or  vaseline  with  clean  gauze  and  w^ash  in  hot  water  and 


CLEANLINESS    OF    THE    FEET 


29 


soap  to  remove  last  vestiges  of  grease.  Knives  should  not  be 
boiled  as  boiling  tends  to  dull  sharp  instruments.  Sterilize 
by  placing  in  a  five  per  cent,  solution  of  carbolic  acid  for  twenty 
minutes  and  then  transfer  to  eighty-five  per  cent,  alcohol. 

Part  should  have  been  previously  cleansed.  Apply  tincture 
of  iodine  three  per  cent.  Allow  to  dry.  Then  ajjply  alcohol 
seventy  per  cent.  Iodine  is  an  admirable  antiseptic  which 
penetrates  the  epidermis  and  fixes  the  bacteria  in  the  skin. 


Fi(..   li. 


-Foot  iii.ii<t(-lC(r'a  cajc  u.^cd  in  i;xptiiuii<iiar> 
States  marine  corps. 


/I   i!ic   Uniti-i! 


CLEANLINESS  OF  THE  FEET 

The  first  essential  in  the  proper  care  of  the  feet,  as  of  the 
body,  is  rigid  attention  to  cleanline.ss.  Where  this  is  neglected 
there  accumulates  an  excessive  amount  of  perspiration,  fatty 
material,  dirt  and  skin  scales  which  tmdcr  the  action  of  bacteria 


30  FOOT    CARE    AND    SHOE    FITTING 

decompose  causing  a  very  ollensive  odor  and  the  skin  to 
disintegrate.  The  individual  then  suffers  from  abrasions, 
bhsters,  tender,  sweaty  and  flaccid  feet. 

To  maintain  a  standard  of  cleanliness  and  relative  freedom 
from  foot  trouble  and  disability,  inspections  should  be  made. 
In  the  barracks  this  inspection  should  be  made  at  least  every 
fortnight.  The  company  commander,  accompanied  by  the 
sergeant  who  takes  notes  if  necessary,  passes  through  the 
barrack  houses  inspecting  each  man  as  he  stands  in  his  bare 
feet  at  the  foot  of  his  bunk.  This  can  be  accomplished  in  a 
very  short  time  if  the  method  is  systematized.  Some  will 
maintain  that  this  is  repugnant  and  beneath  the  dignity  of  an 
officer.  But  the  same  is  true  of  many  other  things  in  military 
life.  vSurely  if  cavalry  officers  take  scrupulous  care  of  the 
hoofs  of  their  horses,  infantry  officers  can  do  the  same 
with  the  feet  of  their  men.  One  is  just  as  important  as 
the  other. 

In  the  field,  inspections  are  even  more  imperative.  The 
feet  should  be  inspected  before  and  after  every  march  so  that 
all  minor  and  trivial  injuries  can  be  attended  to  promptly  and 
prevented  from  becoming  serious  disabling  affections  which 
cripple  the  efficiency  of  a  command. 

Daily  foot  baths  of  cool  or  tepid  water  with  just  enough 
soap  to  cleanse  should  be  taken.  Do  not  soak  the  feet  as  this 
softens  the  skin.  If  hovisehold  ammonia  is  procurable  a  few 
drops. of  that  in  a  basin  is  advisable.  Cool  or  cold  water  is  to 
be  used  because  it  not  only  hardens  the  skin  and  eases  the 
sensation  of  burning  after  a  march  but  also  increases  the  tone 
of  the  foot.  By  tone  is  meant  a  stimulation  whereb}^  the 
muscles  are  held  in  a  state  or  condition  of  continuous  contrac- 
tion ready  to  respond  quickly  to  the  slightest  call.  After  a 
cold  bath  we  all  feel  much  better  and  anxious  to  do.  This 
condition  in  modern  terminology  is  called  "pep."     So  let  us 


CLEANLINESS    OF    THE    FEET 


U 


a\'  tliut  cold  water  gives  "  pep  "  to  a  tired  foot.     Alter  \v;isliin^' 
"1"  course  the  feet  should  be  thorouj^hly  dried. 

In  the  field  the  feet  should  be  washed  and  the  socks  changed 
before  and  after  every  hike.  Water  is  usually  present  in  the 
form  of  springs,  wells  or  streams.  By  scraping  a  hole  in  the 
ground  over  which  is  spread  a  poncho,  a  suitable  basin  is 
readily  made  into  which  water  may  he  poured  from  a  canteen. 


1   I'.      I  ;        I'mik  hn  hasiii  .'is  iiscil   in   i  lu-   fl 


Where  water  is  scarce  just  a  few  sjjoonfuls  pcnnx'd  on  a  towel, 
handkerchief  or  paper  and  ai)plied  between  the  toes  suffices. 
In  extreme  cases  saliva  on  a  handkerchief  can  be  used  to 
advantage. 

Both  in  the  past  anrl  at  j)resent  the  nails  according  to  an 
unassailal>le  custom  have  been  cut  "round."  The  corners 
should  not  be  trimmed  ofT  as  this  encourages  a  nail  to  grow  into 
the  flesh  resulting  in  an  ingrown  nail.     Nails  should  he  cut 


32 


FOOT   CARE   AND   SHOE   FITTING 


Straight  across  about  every  two  weeks.  Nails  deformed  b\ 
overgrowth,  such  as  unusually  thick  nails  and  clubbed  nails, 
can  be  remedied  by  soaking  in  hot  water  and  paring  do^^^l  with 
a  knife  or  rubbing  down,  with  sand-paper.  The  material 
under  the  nails  shoiild  be  removed  with  an  orange  stick,  not 
with  the  point  of  scissors  and  the  like. 


Correct  way.  Incorrect  waj'. 

Fig.   14. — Trimming  of  toe  nails. 


BLISTERS  AND  ABRASIONS 

The  most  common  causes  of  blistering  are:  friction,  pres- 
sure or  impact.  Accessory  causes  are  ill-fitting  shoes  and 
socks,  overriding  toes,  hammer  toes,  poorly  constructed  un- 
even cheap  shoes,  heat,  moisture  and  uncleanliness.  They 
are  most  often  found  in  those  whose  foot  skin  is  tender  and 
soft,  e.g.,  among  newly  recruited  troops  and  those  not  accus- 
tomed to  long  hiking.  The  points  usually  affected  are:  the 
outer  surface  of  the  little  toe,  upper  surface  of  the  toes,  surface 
and  back  of  heel,  upper  surface  of  foot  under  the  shoe-laces, 
ball  of  the  foot  and  over  the  Tendo  achillis  (the  large  tendon 
attached  to  the  upper  surface  of  the  heel  bone).  The  forma- 
tion of  blisters  is  a  protective  process.  Irritation  of  the  outer 
or  false,  and  inner  or  true  skins  being  continuous,  there  arises 
an  inflammation  of  both,  during  which,  the  inner  skin  exudes 


BLISTERS    AND    ABRASIONS  33 

an  inflammatory  fluid  and  raises  the  outer  thus  forming  a 
blister. 

Treatment  is  directed  primarily  toward  the  cause.  Inspect 
and  remedy  defects  in  the  shoes  or  socks,  such  as  nails,  fallen 
toe  cap,  ill-fitting  insoles,  worn  lining,  tight  lacing,  uneven 
stitching  as  over  the  Tendo  achillis  posteriorly  and  badly 
worn,  darned,  small  or  dirty  socks.  Apply  to  blister  tincture 
of  iodine  3,^  per  cent,  or  grain  alcohol.  Immerse  needle  in 
alcohol  or  heat  in  flame  and  puncture  at  the  base,  allowing 
fluid  to  escape  and  covering  (outer  skin)  to  collapse  on  the 
inner  or  true  skin  thus  protecting  the  latter  and  minimizing 
infection  (invasion  of  microbes).  The  blister  (outer  or  false 
skin)  should,  therefore,  not  be  torn  or  removed. 

Dry  the  skin  with  gauze  or  aljsorlient  cotton  and  cover  the 
blister  with  adhesive  plaster  which  should  be  firmly  pressed 
down  so  that  the  raised  outer  skin  or  epidermis  will  be  forced 
into  position.  The  adhesive  may  be  made  to  stick  well  by 
heating  it  with  a  match  or  apj^lying  ether  if  the  latter  is  to  be 
had.  Should  it  be  impossible  to  procure  adhesive  plaster, 
then  sterile  vaseline,  boric  acid  ointment  or  zinc  oxide  oifil- 
ment  may  be  ai^jjlied  with  benefit.  If  these  last-named 
articles  are  at  a  premium,  the  regulation  foot-i)owder  may  be 
dusted  on  the  part  and  a  few  turns  of  a  gauze  bandage  made. 
All  the  dressings  being  comjWcted,  a  moderate  amount  of  the 
foot-powder  should  be  dusted  on  them  and  in  the  shoe.  The 
powder  prevents  the  edges  of  the  adhesive  from  adhering  to 
the  sock  and  lessens  friction  in  the  shoe  cavity.  Too  nnuh 
powder  is  just  as  bad  as  none  at  all  as  a  large  quantity  tends 
to  cake  and  form  uneven  surfaces.  Search  should  l)e  made 
for  all  areas  which  are  red  and  tender  with  no  formation  of 
blisters.     Adhesive  jjlaslcr  should  be  jjlaced  over  these. 

Heel  blisters  occupy  such  a  i)rominent  i)lace  in  the  category 
of  transient  foot  ills  that  they  shouhl  be  given  careful  attention. 
3 


34  FOOT    CARE    AND    SHOE    FITTING 

Usually  caused  by  bad  socks  or  poorly  constructed  ill-fittin.u 
shoes  allowing  the  heel  to  slip,  they  form  by  far  the  great 
majority  of  blisters.  The  structural  defects  of  the  shoe  are 
usually  such  as  (a)  heel  too  narrow  or  broad  (b)  shoe  too  long 
(c)  shoe  too  broad  across  the  instep  with  high  heels  (d)  incorrect 
posterior  curve  of  shoe  not  conforming  to  heel  and  tendon  and 
(e)  improper  lacing.  In  the  individual  with  a  long,  narrow 
foot  and  narrow  heel,  or  the  one  with  a  broad  foot  and  narrow 
heel,  much  benefit  can  be  derived  by  placing  a  felt  pad  varying 
in  thickness,  corresponding  to  the  tongue  of  the  shoe  in  size 
and  posterior  to  it.  The  greater  part  of  these  blisters  will  be 
avoided  bj^  a  proper  measurement  and  fitting  where  the  heel 
is  regarded  with  more  care.  The  figure-of-eight  marching 
strap,  originally  devised  and  used  by  the  French,  will  prevent 
the  heel  from  slipping  up  and  down,  on  the  march  in  the  great 
majority  of  cases. 

Abrasions  are  nothing  more  or  less  than  blisters  with  the 
raised  outer  skin  or  epidermis  removed  exposing  the  rose  red 
derma  or  inner  skin.  They  are  very  painful  due  to  the  fact 
that  the  sensitive  nerve  endings  in  the  derma  or  inner  skin  are 
vmprotected  and  exposed  to  changes  of  temperature  and  injur- 
ies. In  the  blister,  on  the  other  hand,  these  nerve  endings  are 
protected  by  the  raised  epidermis  and  accumulated  inflam- 
matory fluid.  The  causes  of  2lbrasions  correspond  to  the 
causes  of  blisters.  The  treatment  is  primarily  corrective. 
The  cause  should  be  sought  for  and  remedied.  Protective 
treatment  includes  the  applying  of  alcohol  (grain)  or  iodine 
33^  per  cent,  to  the  area  then  zinc  oxide  adhesive  plaster.  In 
lieu  of  the  adhesive  plaster  zinc  oxide  or  boric  acid  ointment 
may  be  applied  plus  a  few  turns  of  a  gauze  bandage. 

In  the  prevention  of  blisters  and  abrasions  there  are 
three  factors  which  determine  the  functional  integrity  of 
the  foot: 


FOOT    STRAIN  35 

1 .  Proper  measuring  of  feet  and  fitting  shoes. 

2.  Proper  corresponding  sock — size. 

3.  (a)  Feet  inured  to  hiking  or  (b)  prepared  for  such. 

The  proper  measuring  of  the  feet  and  accurate  fitting  shoes 
together  with  the  correct  corresponding  sock-size  will  be  dis- 
cussed in  full  later.  That  feet  inured  to  hiking  will  escape 
much  injury  is  self  evident.  At  this  point,  however,  should  be 
mentioned  the  appH cation  of  formaldehyde  Sol.  10  per  cent,  on 
alternate  days  for  six  applications  to  the  soles  of  the  feet  and 
especially  points  exposed  to  pressure.  This  serves  to  harden 
the  skin  and  lessens  the  chance  of  inflammation.  Adhesive 
jjlaster  may  be  placed  over  suspicioned  pressure  points  before 
the  miarch  to  escape  the  formation  of  blisters  together  with 
the  same  weight  socks  the  shoes  were  fitted  with. 

FOOT  STRAIN 

Because  of  the  inherent  facility  of  the  layman  to  attribute 
any  and  every  foot  ill  to  flat-foot  or  a  tendency  thereto,  many 
of  the  uninitiated  and  inexperienced,  influenced  by  the  jjopular 
trend  of  belief,  readily  diagnose  this  conditicm  ius  such.  That 
such  a  step  has  a  very  decided  and  marked  effect  on  the 
neurotic  individual,  and  gives  many  persons  the  golden 
opportunity  to  malinger,  is  self  evident. 

To  begin  with,  the  reader  should  thoroughly  understand  that 
this  affection  is  f)ftcn  associated  with  a  visibly  normal  foot  or 
foot  j)Osture  where  theligamentshave  not "  given  "  or  stretched; 
or  with  a  visibly  abnonnal  foot  or  foot  ])osture  where  the 
ligaments  have  "given."  In  short,  the  condition  may  be 
functional  f)r  organic.  Whenever  there  appears  a  local, 
reddened,  jjainful  swelling  in  ruldition  I0  other  s\-mjitoms 
infection  should  be  susjjccled. 

This  cfjndilion  usually  occurs  ni  the  case  of  the  raw  re<riin. 
from  a  recent  sedentary  occupation ,  whose  foot  muscles  have 


36  FOOT   CARE    AND    SHOE   FITTING 

not  been  given  the  chance  to  develop  gradually.  However, 
it  may  happen  in  an  individual,  a  veteran  may  be,  who  has 
recently  recovered  from  some  debilitating  infectious  disease 
with  a  consequent  loss  of  muscular  tone  and  strength,  or  in 
the  hardened  soldier  who  has  been  marched  far  past  his  limit 
of  endurance.  Exceptions  occiir  where  the  gradually  trained 
man  is  affected  during  his  period  of  training  ^despite  all  pre- 
cautions. These  exceptions  depend  upon  individual  physical 
idiosyncracies. 

Where  a  burden  is  borne  by  muscles  not  developed  to  meet 
that  special  requirement  and  where  the  muscles  are  not  given 
a  sufficient  period  of  reaction  or  rest  there  results  a  condition 
of  musciilar  fatigue,  acute  or  chronic.  Together  with  this 
there  may  be  some  tearing  of  the  fibers  constituting  the  muscu- 
lar bundles  due  to  overstretching  of  the  latter.  The  muscles, 
being  fatigued  or  torn,  fail  to  support  the  burden  and  shift  the 
responsibility  to  the  tough  fibrous  ligaments.  These  are  not 
supplied  by  nerves;  give  no  sensation  of  pain,  and  are  inelastic. 
Because  of  their  inelasticity  weight  applied  directly  causes  a 
transmission  of  tension  to  the  periosteum  (covering  of  bone) 
to  which  they  are  attached.  The  periosteum  being  richly 
supplied  with  nerves  and  having  traction  applied  to  it  give 
rise  to  the  sensation  of  pain.  The  degree  of  pain  will  vary 
according  to  amount  of  traction  exerted  by  the  ligaments  on 
the  periosteum.  According  to  the  weight  borne,  degree  of 
strain  and  consequent  shifting  of  the  burden  to  the  ligaments 
will  depend  whether  the  latter  stretch  or  not.  This  whole 
sequence  of  events,  as  described,  may  be  caused  by  an  excess 
of  use  or  load  for  that  individual,  or  use  in  an  improper  manner. 

The  symptoms  are  very  inconstant,  elusive  and  deceiving  at 
times.  Pain  and  soreness  may  occur  under  the  arch,  over  the 
arch,  surface  of  the  heel,  ball  of  the  foot,  outer  border  of  the 
foot  or  in  the  calf  muscles.     Characteristic  of  the  pain  is  its 


FOOT    STRAIN  37 

sudden  acute  appearance,  and  increasing  intensity  when  use  is 
attempted.  This  pain  often  severe  and  lancinating  may  skip 
from  place  to  place  or  remain  stationary.  To  diagnose  this 
condition  requires  the  attention  of  a  surgeon.  However,  the 
condition  may  be  suspected  when  the  arch  and  scaphoid  bone 
in  examination  are  found  wqII  up  and  the  muscular  dcveloj)- 
ment  of  the  sole  of  the  foot  is  fair  or  good. 

Feet  presenting  such  severe  symptoms  necessarily  conduce 
to  inefficiency  of  the  organization  and  demand  the  attention  of 
the  regimental  or  orthopedic  surgeon.  However,  until  surgical 
attention  can  be  procured,  simple  measures  may  be  undertaken 
for  temporary  relief  in  mild  cases.  The  feet  should  be  treated 
by  altematingly  immersing  them  first  into  a  bucket  of  hot 
water  and  then  into  one  of  cold  water  for  about  a  period  of  ten 
minutes  three  times  a  day.  This  is  the  "contrast  bath" 
which  aids  in  alleviating  the  symptoms  by  bringing  more 
blood  to  the  part  for  re])air  of  damage  and  also  causes  an  in- 
creased tone  of  the  muscles  both  of  the  feet  and  blood  vessels. 
Massage,  with  short  quick  strokes,  applied  to  the  arch  and 
other  points  of  pain  is  also  beneficial,  and  should  1)0  i)ractised 
three  timos  a  day  for  about  ten-minute  periods. 

The  common  liniments,  or  i)lain  ethyl  (grain)  alcohol  may 
be  used. 

Upon  retiring  at  night,  an  elastic  bandage  aj^plied  to  the  foot 
and  holding  it  in  position  of  adduction  and  sui)ination  is  very 
helpful. 

To  affect  a  static  correction  the  heels  of  the  .shoes  may  be 
raised  j-^-j  ^  inch  on  the  inner  side  by  the  insertion  of  leather 
wedges  between  the  lifts.  The  use  of  artificial  suiii)orls, 
extensively  advertised  at  present,  is  not  comj»alible  with  the 
pedestrial  activity  of  military  life.  However,  in  very  urgent 
cases,  they  may  be  used  for  short  periods;  the  inrlividnal  being 


38  FOOT    CARi:    AM)    SIIOK    FITTING 

placed  on  light  duty  until  the  condition  is  alleviated,  when  the 
supports  are  discarded. 

In  all  cases  where  foot  strain  has  been  incurred  j^radual 
increased  exertion  and  weight  bearing  must  be  practised  if  a 
recurrence  is  to  be  avoided. 

HALLUX  VALGUS 

In  this  condition  the  great  toe  is  deflected  toward  the  outer 
side  of  the  foot  accompanied  by  structural  changes  in  the  great 
toe  joint  (first  metatarsophalangeal  joint) .  (vSee  plate  No.  15.) 
With  this  is  usually  associated  an  enlargement  of  the  bursa,  a 
small  sack  situated  on  the  inner  side  of  the  joint.  The  en- 
largement of  the  bursa,  caused  by  an  acute  or  chronic  inflam- 
mation, constitutes  what  is  called  a  bunion.  Accompanying 
this  bunion,  or  alone,  there  may  occur  a  thickening  of  the 
periosteum  (covering  of  the  bone)  forming  an  exostosis  (out- 
growth). A  point  of  great  importance,  deserving  careful 
attention,  is  that  the  anterior  arch  usually  falls  with  the 
occurrence  of  all  cases  of  Hallux  Valgus  excepting  the  mild 
ones. 

This  aftection  is  caused  by  the  individual's  wearing  pointed 
toe  shoes  of  the  English  type  in  which  the  inner  side  of  the 
sole  is  not  a  continuation  of  a  straight  line  formed  by  the  heel 
but  curves  outward  thereby  causing  the  shoe  upper  to  press 
against  the  great  toe  and  great  toe  joint  resulting  in  deformity 
when  worn  for  any  length  of  time.  The  great  and  almost 
universal  prevalence  of  this  condition  is  due  to  the  popularity 
of  the  pointed  toe  shoe. 

Treatment  is  directed  toward  mitigating  the  condition  or 
more  radical  treatment  such  as  operative  measures.  The 
former  will  be  discussed.  Before  anything  is  done  the  shoe 
should  be  inspected,  the  fit  verified  and  the  lining  examined  to 


HALLl'X   VALGUS 


39 


Fl(,.    IS-      AiilrTi"r  viiw  III   .itinormal  Iri-t.      Note-  ci«]iri-sM'iti  ol   lllll^;il^l'lilUll 
an  lies.      Marked   hallus  valgus. 


40  FOOT   CARE   AND    SHOE   FITTING 

see  if  there  are  any  wrinkles  present.  Should  the  shoe  be 
correct  in  fit  the  inner  edge  of  the  sole  may  be  raised  by  the 
insertion  of  leather  wedges  }  g  to  ^{q  inch  thick  which  throw  the 
weight  and  consequent  pressure  away  from  the  affected  joint 
and  toe.  Again,  a  wad  of  gauze  or  felt  pad  held  by  adhesive, 
just  back  of  the  great  toe  joint  relieves  harmful  pressure  and 
permits  the  great  toe  to  move  more  freely.  In  all  cases  where 
facilities  are  at  hand  the  feet  should  be  carefully  measured 
and  shoes  accurately  fitted. 

If  the  shoes  fit  satisfactorily  and  are  correct  in  other  details 
additional  comfort  may  be  had  by  stretching  the  leather 
opposite  the  great  toe  joint.  The  military  shoe  with  .plenty 
of  room  across  the  ball  of  the  foot  and  a  sole  whose  inner  side 
is  a  continuation  of  a  line  from  the  inner  side  of  the  heel  will 
gradually  improve  mild  cases. 

HALLUX  RIGIDUS 

(Rigid  Great  Toe) 

This  condition  involves  the  big  toe  joint  and  to  such  an 
extent  that  there  is  a  limitation  of  motion,  especially  upward 
(dorsal  flexion) .  The  symptoms  may  be  of  an  acute  or  chronic 
nature.  Acute  symptoms  appear  when  the  joint  is  used  con- 
siderably, which  use  ma}^  be  excessive  for  the  particular  joint 
involved,  and  consist  of  reddening  of  the  skin,  swelling  and 
pain  when  a  movement  is  attempted.  In  those  cases  where 
the  acute  symptoms  are  not  present,  theryc  is  a  symmetrical 
enlargement  of  the  joint,  or  at  one  point  only,  and  the  limited 
motion  spoken  of.  These  are  due  to  the  abnormal  production 
of  bone  around  the  margin  of  the  joint. 

It  is  caused  by  pointed  toe  shoes  of  the  English  type,  shoes 
too  narrow  for  the  width  of  the  ball  of  the  foot  with  high  heels, 
and  shoes  too  short  for  the  individual. 


HAMMER    TOE  4  I 

Treatment  primarily  is  corrective.  Investigate  the  size  of 
the  socks.  Measure  the  foot  and  accurately  fit  the  individual 
according  to  the  present  standard.  In  slight  cases,  treatment 
is  also  directed  to  allaying  the  acute  s}Tnptoms  which  may  be 
benefited  by  immersing  the  foot  in  cold  water  ana  sufficient 
rest.  In  cases  of  chronic  symptoms  much  good  can  be  done 
by  applying  a  cleat  of  leather,  four-sixteenths  of  an  inch  to  one- 
quarter  inch  thick  and  one  and  one-half  inches  wide  to  the  sole 
of  the  foot  back  of  the  heads  of  the  metatarsal  bones  (back 
of  the  ball  of  the  foot.) 

HAMMER  TOE 

This  condition  or  deformity,  usually  in\olving  the  second 
toe,  causes  the  middle  toe  to  be  permanently  bent  and  project 
upward.  As  a  result  of  this  prominent  upward  projection, 
there  is  excessive  friction  with  the  upper  of  the  shoe,  causing 
painful  corns.  The  whole  toe  necessarily  not  taking  part  in 
the  gripping  action  of  locomotion,  all  the  burden  is  assumed  by 
the  end  of  the  toe  which  becomes  tender,  irritated  and  finally 
calloused.  In  addition  the  toe-nail  is  often  forced  backward, 
resulting  in  a  cluVjbed  or  ingrowing  nail. 

Treatment  'can  relieve  the  mild  cases  to  a  certain  extent. 
Strap  a  small  pad  of  gauze  or  felt  on  top  of  the  toe,  either 
in  front  of  or  just  back  of  the  i)rominent  joint.  Apply  two 
strips  of  adhesive  tape  ^(g  inch  wide  to  IkjUI  the  toe  straight. 
The  first  of  these  strijjs  is  placed,  sticky  side  up,  on  the  top  of 
the  toe  just  back  of  the  prominent  joint  and  ihcn  passed 
under  the  two  adjacent  toes,  drawn  comfortably  taut  and 
.made  to  adhere;  the  second  strij)  is  j^laced  sticky  side  down, 
underneath  the  affected  toe,  just  in  front  of  the  prominent 
joint  and  then  passed  over  the  tw(j  adjoining  toes,  drawn 
taut  and  made  to  adhere.  Refractory  and  severe  cases 
should  be  examined  and  treated  by  the  Medical  Officer. 


42  FOOT   CARE   AND    SHOE    FITTING 

DEFORMITY  OF  THE  LITTLE  TOE 

This  toe  has  no  especial  pecuHarities  referable  to  its  de- 
formity. The  same  conditions  involving  the  other  toes, 
such  as  Hallux,  Hammer  Toe,  Ingrowing  Nails,  etc.,  occur  in 
a  similar  manner  affecting  this  toe.  The  conditions  being 
essentially  the  same  so  must  be  the  treatment  which  is  given 
on  other  pages. 

INGROWING  NAILS 

These  constitute  a  most  prevalent,  incapacitating,  persist- 
ent and  painful  condition  which  requires  immediate  correction 
and  treatment  if  benefit  is  to  be  obtained  without  operation. 

The  corner  of  the  nail  slopes  with  a  curve  downward  and 
inward  growing  into  the  flesh  and  by  pressure  producing  a 
constant  dull  pain.  Usually  involving  the  great  toe,  but  not 
particularly  sparing  the  others,  it  is  often  accompanied  by 
infection  with  the  consequent  foraiation  of  pus. 

The  cause  is  essentialh^  pressure  exerted  by  ill-fitting  shoes 
which  are  too  short,  too  narrow  across  the  ball  of  the  foot  and 
toes  and  too  broad  across  the  toes  with  high  heels  throwing  the 
foot  forward  each  time  a  step  is  taken. 

Treatment  primarily  is  corrective.  Investigate  the  size  of 
the  sock  worn.  Measure  the  feet  and  accurately  fit  shoes. 
Cut  the  nail  squares  across  and  do  not  cut  the  corners  round. 
To  alleviate  the  pain  caused  b}^  the  pressure  of  the  offending 
nail  the  following  measures  should  be  instituted.  First,  from 
in  front  with  a  sterile  probe  or  forceps  insert  a  small  pledget 
of  cotton  under  the  nail  between  it  and  the  flesh.  Renew  this 
ever}^  day  until  nail  is  diverted  from  its  abnormal  tendenc}- 
and  grows  out  over  the  toe.  Again  the  cotton  may  be  packed 
in  from  the  side  and  the  flesh  pushed  away  from  the  nail. 
Crane  recommends  dentist's  base-plate  gutta  percha  which  he 


SWEATY    FEET  43 

claims  possesses  decided  advanlages  over  cotton.  This  it 
does.  First  cut  a  small  triangular  piece,  carefully  heat  it  in  a 
flame  and  insert  under  the  edge  of  the  nail.  It  molds  itself 
to  the  shape  of  the  parts  and  may  be  left  imtil  the  nail  grows 
in  the  correct  direction.  Where  pus  is  present  apply  tr. 
iodine  3}  2  per  cent.,  alcohol  and  then  liberate  pus  with  sterile 
needle.  Cover  the  part  with  sterile  gauze  and  send  the  intli- 
vidual  to  the  medical  officer. 


SWEATY  FEET 

( Bromidrosis) 

This  condition,  usually  chronic,  is  very  prevalent  and  is 
not  only  disabling,  but  also  annoying  and  ofTensive.  To 
control  it  heroic  measures  must  be  taken  at  the  earliest  oi)i)f)r- 
tunity  and  continued  until  satisfactorN'  benefit  is  derived  or 
complete  cure  obtained. 

The  sweat  glands  being  unusually  actne  in  an  indivitlual 
with  a  very  unstable  circulatory  or  nervous  system,  there  forms 
an  excessive  quantity  of  sweat  which  collects  on  the  skin  sur- 
face in  a  dried  or  lifpiid  state.  Mi.xed  with  skin  debris,  fatty 
material  an<l  dirt  it  forms  an  ideal  c-ulture  medium  for  organ- 
isms which,  acting  upon  the  mass,  cause  decomposition.  As 
a  result  of  this  and  the  constant  moisture  the  skin  l)ecomes 
very  soft,  exquisitely  tender  and  jjainful  to  ]jressure  and  easil\- 
comes  oil,  thus  forming  blisters  and  abrasions.  The  appear- 
ance of  the  feet  is  characteristic.  They  are  congested  and 
inflamed  with  scattered  areJis  of  red  and  white,  sometimes 
interspersed  with  a  blue-])urple  mottling. 

Treatment  consists  of  a  daily  or  bi-daily  foot  bath  of  cohl 
water  using  as  little  of  a  hijjh  grade  toilet  soaj)  as  ])ossible. 
(^'hange    socks    daily    or    bi-daily   and    wear,    if    procurable, 


44  rOOT   CARE    AND    SHOE   EITTING 

canvas  or  cloth  slippers  with  leather  soles.  Leather  shoes 
aggravate  the  condition  because  the  pores  of  the  leather 
become  occluded  by  the  sweat  and  dirt,  which  forms  an  im- 
penetrable barrier  that  prevents  evaporation.  Individual 
treatments  which  have  been  successful  are  as  follows : 

1 .  Wash  the  feet  with  cold  water. 

2.  Dry  carefully. 

3.  Carefully  apply  to  affected  areas  with  cotton  tipped 
applicators  the  following : 

(A)  Commercial  formalin  (40  per  cent. 

sol.  of  formaMehyd parts  10 

(B)  Water parts  90 

Stillmans  recommends  a  25  per  cent,  solution  of  aluminum 
chloride  in  distilled  water,  dabbed  gently  on  the  part  every 
second  or  third  day  and  allowed  to  dry.  This  will  cause  rapid 
amelioration  of  the  condition.  Three  applications  are  usually 
sufficient.  If  the  condition  recurs  treatment  may  be  repeated. 
Pure  glycerine  rubbed  on  the  feet  has  been  recommended. 
After  a  successful  treatment,  a  foot  powder  in  small  quantities 
may  be  placed  in  the  shoe. 

Formula  of  which  is  given  below: 

Salicylic  acid 3  parts 

Boric  acid 10  parts 

Talcum  powder 87  parts 

CORNS 

(Horny  Thickenings  of  the  Skin) 

Corns  are  localized  callosities  or  horny  thickenings  of  the 
skin  usually  resulting  from  ill-fitting  shoes.  They  are  pro- 
tective in  nature.     Where  excessive  impact,  friction,  or  pres- 


CORNS  45 

sure  has  existed  there  usually  results  an  area  of  tenderness,  a 
blister  or  an  abrasion.  To  remedy  the  existing  evil  and  to 
prevent  a  repetition,  natiu-e  causes  to  be  formed  a  hard  horny 
layer  of  skin  which  protects  the  particular  part  from  further 
injury.  If  the  cause  continues  the  layers  of  hardened  skin 
multiply  and  increase  the  thickness  of  the  corn.  Finally 
prolongations  downward  into  the  sensitive  true  skin  are  formed 
and  pressing  on  ner\'es  cause  pain.  These  callosities  are  most 
commonly  found  on  the  tops  of  the  toes,  between  the  toes,  on 
the  outer  aspect  of  the  little  toe,  on  the  ball  of  the  foot  under 
the  anterior  arch  and  on  the  margin  of  the  heel. 

The  importance  of  this  subject  consists  in  its  unusual  and 
extreme  prevalence;  and  disabling  features  which  do  much  to 
reduce  the  marching  ability  of  a  military  organization.  The 
cause  of  corns  is  found  in  ill-fitting  shoes  worn  at  the  time  of 
examination  or  previously.  To  detennine  this  is  imperative 
because  if  the  cause  is  not  removed  there  will  certainly  be  a 
recurrence  of  the  condition.  To  remedy  the  latter,  the  shoes, 
if  not  suital>le  to  adjustment,  should  be  discarded  or  the  shoe 
stretcher  used  in  satisfactory  shoes  to  remove  friction  and 
pressure. 

It  requires  almost  constant  attenticm  to  bring  relief  from 
corns  if  their  entire  removal  is  not  contemplated.  The  feet 
are  soaked  in  warm  water  for  a  period  of  fifteen  minutes  and 
the  corn  i)ared  down  every  week  or  so,  care  Ijcing  taken  not 
to  be  overzealous  in  cutting  deep  and  drawing  Ijlood.  When 
this  is  done  measures  must  be  taken  immediately  to  check  any 
infection  because  infections  of  the  feet  are  very  serious.  Apply 
to  the  area  from  which  the  blood  is  (jozing  Tr.  Iodine  3^  per 
cent.,  then  alcohol  and  cover  with  adhesive  or  apply  directly 
the  salicylic  acid-collodion.  The  paring  of  corns  is  a  tem- 
porary, not  a  pennanent  mea.sure,  and  is  not  recommended. 
To  .soften  the  homy  tissue  so  that  the  whole  corn  will  in  a 


46  FOOT    CARE    AND    SHOE    FITTING 

short  Lime  come  out  ami  1)C  cured  ])C!nnanenll\'  uothinjj;  is 
better  than  the  followinj;  combinatiou. 

SaHcyHc  acid Grains  xv 25  grains 

Flexible  collodion Oz.  i 1  ounce 

This  is  supplied  by  the  medical  department  and  is  often  supe- 
rior to  any  patented  remedy  on  the  market.  The  claims  of 
manufacturers  of  corn  remedies  to  remove  a  corn  in  a  night  are 
false  and  the  opportunity  is  here  taken  to  inform  officers  of 
the  service  that  such  is  so.  The  solution  above  given  is  in- 
flammable and  should  not  be  near  lighted  matches,  cigarettes, 
etc.  The  bottle  should  be  kept  tightly  corked  as  evaporation 
is  rapid  when  the  contents  are  exposed  to  the  air.  The  method 
of  removing  corns  is  as  follows : 

(a)  Wash  the  foot  thoroughly. 

(6)  Immerse  in  hot  water  about  15  minutes.  When  with- 
drawn note  that  the  color  of  the  corn  is  white  and  is  soft  to 
the  touch. 

(c)  Dry  the  foot  thoroughly. 

(d)  Apply  the  sa'icylic-collodion  to  the  corn  and  about  one- 
eighth  of  an  inch  around.  Allow  to  dry.  Apply  another  layer. 
Application  is  made  with  a  glass  rod  or  wooden  applicator. 

(e)  Apply  adhesive  plaster. 

This  should  be  done  on  an  average  every  day  for  four  treat- 
ments. Sometimes  even  four  treatments  do  not  suffice  and 
applications  must  be  continued.  Where  the  upper  layer  of 
the  corn  is  particularly  hard  a  thin  slice  may  be  pared  off  so 
that  the  salicylic  acid-collodion  can  effect  the  tissue. 

At  the  end  of  the  course  of  treatment  it  will  be  found  that 
the  com  has  a  dead  white  appearance.  With  the  end  of  tissue 
forceps  or  the  back  of  the  blade  of  a  knife  slide  it  under  the 
loose  dead  skin  at  the  margin  of  the  corn  and  proceed  around 


CONDITIONS    APFECTING    THE    AXTF.RIOR    ARCH  47 

the  com.  Take  care  while  prying  the  corn  loose  from  the 
tissue  not  to  cut  the  roots  of  prolongations  which  extend  down- 
ward into  the  flesh  because  if  these  are  severed  the  corn  will 
recur.  The  whole  treatment  is  directed  toward  removing  the 
whole  corn  en  masse  with  its  roots  and  not  piece-meal.  Bleed- 
ing should  not  be  caused  when  the  corn  is  pulled  out  completely 
down  to  the  derma  or  true  skin  (the  quick) . 

The  treatment  described  is  best  done  while  the  men  are  in 
barracks;  and  should  a  march  be  taken  immediately  or  soon 
after  the  sensitive  areas,  formerly  occupied  by  corns,  may  be 
covered  with  adhesive. 

As  callouses  and  corns  are  similar  the  treatment  directed 
to  remedying  the  former  is  the  same  as  the  latter.  Lastly, 
attention  should  be  given  to  the  fact  that  the  cause,  ill-fitting 
shoes,  must  be  removed  or  the  condition  will  recur. 

CONDITIONS  AFFECTING  THE  ANTERIOR  ARCH 

(Conditions  Affecting  the  Ball  of  the  I'oot) 

As  a  consequence  of  the  anterior  arch's  falling  or  flattening 
there  arc  two  very  important  conditions  which  attract  our 
attention.  They  are  namely,  callous  fomiations  im  the  sole 
of  the  foot  over  the  heads  (^f  the  metatarsal  bones  (ball  of  the 
foot),  accompanied  either  with  or  without  i)ain  and  metatar- 
salgia  (pain  in  the  fourth  metatarsal  joint).  These  conditions 
although  not  as  prevalent  as  flat-foot  still  are  of  such  a  dis- 
abling character  that  their  description  should  be  given. 

T .  Callous  Formations  on  the  Hall  of  the  Foot  over  the  Metatar- 
sal Heads  with  or  without  Pain.—Whi^n  the  distal  ends  ()f  the 
metatarsal  bones  which  form  the  anterior  arch  fall,  they  press 
downward  ujjon  the  underlying  muscles,  tendons,  fat  and  skin. 
Nature,  to  jjrotect  the  skin  and  to  f(jrm  a  sui:)])orting  ])tu\, 
causes  callous  to  be  formed  which  may  cau.se  exquisite  jiain 


48  FOOT   CA"RE    AND    SHOE    FITTING 

upon  pressure  similar  to  the  familiar  acute  pain  of  the  "stone 
bruise."  The  callous  is  fonned  most  frequently  over  the  head 
of  the  second  metatarsal  bone.  In  severe  claw-feet,  where 
the  toes  are  contracted  presenting  high  prominences  on  their 
upper  surface,  callosities  may  be  present  over  the  heads 
of  all  the  metatarsal  bones  and  give  rise  to  great  pain  and 
disability. 

2.  Metaiarsalgia  {Morton's  Disease). — In  this  condition 
there  is  severe  neuralgic  pain,  sharp  or  burning  in  character, 
often  of  paroxysmal  occurrence  beginning  on  either  side  of  the 
distal  (far)  end  of  the  fourth  metatarsal  bone  and  passing  up 
the  foot  and  often  up  the  leg.  The  cause  is  badly  fitting  shoes 
which  cause  the  arch  to  fall;  the  metatarsal  bones  to  be  dis- 
placed and  pinching  of  the  nerves  between  the  heads  of  the 
third  and  fourth  and  fifth  metatarsal  bones.  The  transverse 
arch  formed  by  the  distal  ends  of  the  metatarsal  bones  is 
flattened  and  the  foot  broadened;  there  may  or  may  not  be 
flat-foot  (See  illustration  No.  5). 

The  pain  usually  comes  on  when  walking  is  attempted  and 
is  often  so  severe  as  to  cause  the  patient  to  immediately  remove 
the  shoe  and  rub  the  foot. 

Treatment.  The  cause  of  both  conditions  being  essentially 
the  same,  and  since  they  are  often  associated,  their  treatment 
is  practically  identical.  Relief  may  be  had  by  mechanically 
supporting  the  depressed  arch.  Where  the  pain  is  acute,  and 
temporary  relief  is  imperative,  resort  may  be  had  to  adhesive 
straps  applied  transversely  back  of  metatarsal  heads  (ball  of 
foot)  over  properly  shaped  gauze  or  felt  pads.  Supports  as 
used  in  civil  life  are  incompatible  to  the  a  tivity  of  military 
Hfe.  The  best  appliance,  in  military  life  is  a  cleat  of  leather 
one-fourth  of  an  inch  thick  and  one  inch  wide  fastened  to  the 
sole  of  the  shoe  just  back  of  the  metatarsal  heads.  (Ball 
of  foot) . 


AFFECTIONS    OF    THE    HEEL  49 

AFFECTIONS  OF  THE  HEEL 

The  affections  of  the  heel  in  order  oi  their  importance  are: 

1.  Tenosynovitis  (inflammation  of  the  heel  tendon  and 
sheath). 

2.  Bursitis  (inflammation  of  the  little  sac  lying  over  the 
heel  tendon). 

3 .  Periostitis  (inflammation  of  the  covering  of  the  heel  bone 
at  the  point  of  attachment  of  the  heel  tendon) 

4 .  Exostoses  (outgrowths  of  bone  commonly  due  to  a  previous 
infection  of  gonorrhea). 

The  cause  of  these  conditions  is  usually  mechanical;  being 
due  to  badly  fitting  .shoes  or  leggins  causing  friction  and  pres- 
sure In  tenosynovitis,  which  by  the  \va\'  is  very  common  in 
foot  roops,  there  is  swelling  and  tenderness  along  the  tendon 
associated  with  a  grating  .sound  which  may  be  elicited  if  the 
hand  is  placed  on  the  tendon  involved  and  the  foot  moved  U]) 
and  down.  Where  bursitis  exists  there  are  tenderness,  swell- 
ing and  signs  of  fluid;  in  periostitis  there  is  u.sually  not  much 
swelling  but  extrene  tenderness  is  found  at  the  attachment 
of  the  heel  tendon  into  the  heel  bone  and  may  involve  the 
surrounding  bone.  Exostoses  may  or  may  not  be  felt.  Diag- 
nosis u.sually  made  by  Ar-ray,  chronicity  and  ])reA'i"iw  liwtnrv- 
of  gonorrhea. 

Treatment.  Remove  jirimariiy  the  excessive  pressure  or  fric- 
tion by  new  .shoes  or  leggins  or  adjustment  or  the  same.  Strap 
pads  of  felt  or  cotton  to  the  leg  just  above  toe  point  involved 
when  the  tendon  is  affected  and  just  IdcIow  when  the  bursa  or 
tendon  attachment  is  involved.  Alternately  immersing  the 
foot  in  hot  and  cold  water — ' '  contrast  baths ' ' — often  does  good. 
Strapping  adhesive  tape  two  to  three  layers  thick  transversely 
across  the  tendon  is  of  benefit  in  tenosynovitis.     The  heel  tnny 


50 


FOOT    CARE    AND    SHOE    FITTING 


be  raised,  to  relieve  the  strain,  one  half  to  one-quarter  of  an 
inch.  In  acute  cases  where  the  pain  is  exquisite  and  walking 
impossible,  rest  is  imperative;  which,  combined  with  hot 
compresses  and  massage  of  the  neighboring  parts,  avoiding 


Fig.  i6. — Normal  feet  (shoe  wearing).  Note  position  of  ankles  (inner 
sides),  convexity  of  instep  over  anterior  arch.  Slight  hallux  valgus  (out- 
ward deviation  of  both  big  toes). 


the  irritated  area  itself,  is  of  benefit.  Symptoms  are  some- 
times slow  in  disappearing  but  patience  must  be  practised 
and  care  taken  if  a  recurrence  is  to  be  avoided.  Cases  associ- 
ated with  infection  are  very  stubborn  and  should  be  referred 
to  the  surgeon. 


PES    PLANUS  51 

PES  PLANUS 

(Flat-foot) 

In  discussing  a  subject  more  or  less  well  known  to  the  public 
consen-ation  should  be  practised  if  undue  emphasis  and  incor- 
rect impressions  are  to  be  avoided.  It  cannot  truly  be  said 
that  this  subject  does  not  deser\'e  emphasis  and  impression — 
it  does.  However,  on  the  other  hand,  one  should  not  be  led 
to  believe  by  the  flamboyant  statements  of  those  interested 
for  financial  reasons  that  this  condition  is  common  to  the 
degree  that  one-half  of  our  manhood  is  thus  affected.  Such 
statements  and  insidious  advertising  are  made  for  a  purpose. 
The  impression  I  wish  to  make  here  is  that  every  little  ache 
and  pain  in  the  arch  of  the  foot  or  leg  is  not  a  forerunner  of 
this  condition.  Such  s>Tnptoms  may  mean  nothing  but  a 
tired  foot;  a  condition  of  foot  strain  or  bruised  foot.  A 
diagnosis  of  this  condition  cannot  be  made  by  the  s}Tn])toms 
presented. 

An  accurate  diagnosis  requires  more  than  symptoms  and  a 
casual  inspection  of  the  foot.  It  has  been  found  by  extensive 
use  at  this  camp  (Quantico,  Va.)  that  the  method  described 
by  Dr.  Edward  A.  Rich  of  Washington,  D.  C.  has  been  rnosl 
efficient  in  diagnosis  and  altering  shoes  to  fit  abnormal  feet. 
He  has  rightly  said,  "The  diagnosis  of  the  static  foot  defects 
has  always  been  made  largely  by  guess.  Diagitostic  aids 
have  not  been  commonly  sought  or  encouraged.  Manx- 
surgeons,  uninterested  in  foot  subjects,  have  jum])ed  at  con- 
clusions from  mere  inspection,  with  the  usual  result  that 
treatments  ai)])lied  have  been  misfits.  To  diagnose  and  classify 
the  foot  defects  without  gra]jhic  aids  is  exactly  on  a  par  with 
the  attempt  at  diagnosis  and  classification  of  the  chest  de- 
rangements witliout  a  stelhosffipc."  (Sec  subject  of 
Pcdography). 


52 


FOOT  CARE  AND  SHOE  FITTING 


The  principal  causes  are: 

I .  Inherently  weak  and  ill-developed  muscles  of  the  lower 
leg  and  sole  of  the  foot.  These  muscles  being  subjected  to  the 
sudden  bearing  of  excessive  weight  and  work,  or  weight  and 


Pig.  17. — Medial  view  of  normal  foot.      Note  concavitj^  of  longitudinal  arch. 

work  excessive  for  that  particular  individual,  fail  to  support 
the  homy  arch  and  allow  the  latter  to  fall. 

2.  Ill-fitting,   ill-constructed  shoes  causing  incorrect  foot 
posture-toes  turned  out.     The  first  cause  has  been  discussed 


PES    PLANUS 


53 


in  Chapter  2.  The  second  cause  may  be  explained  as  fol- 
lows: Where  the  feet  are  parallel  in  standing  or  locomotion 
the  line  of  ^Yeight  bearing  rtnis  through  the  center  of  the  knee 


Km;.   i8 — Medial  view  of  abnormal  foot.     (Pes  planus  or  flat  foot.)     Note  at 
X   the   depression   of  the   lonRiludinal   an-h. 

cap,  middle  of  the  leg,  and  to  the  cunlcr  of  the  loiigiludinal 
arch.  When  the  toes  are  turned  out  this  line  of  weight  bearing 
is  shifted  inward  on  the  inner  ])ortion  of  the  longitudinal 
arch  whicli  tnav  or  mav  not  b(^  able;  to  bear  the  Iturdcn.      If  not, 


54 


FOOT  CARE  AXD  SHOE  FITTING 


Fi<;.   19. — -Posterior  view  of  feet  practically  normal.     Left  ankle  shows  sliglit 
inversion  (turning  in).     Right  ankle  normal. 


PES    PLANUS 


^v") 


the  inevitable  happens — the  muscles  fail  to  buttress  the  bony 
arch  and  the  latter  fails  with  stretching  of  the  lij^amentous 
attachments. 

Obiectivelv,   in  cases  of  Pes  Planus  inversion  (turnini,^  in) 


I'll,,   jt,.      ruaicriur  view  of  abiiuiiiial  fed.      .\ulc  Uic  inv(.r:,iun  ituriniiK  in) 
of  the  ankles.     A  ca.sc  of  pes  plaints  (Hat-font). 


of  the  ankles  may  l)e  nrtiiicd.  ll.n\«.\ii,  ihis  may  bo  ab.scnt 
or  even  occur  in  the  ojipositc  condition  Pes  Cavus  or  Hollow 
Foot.  This  inversion  of  the  ankles  should  not  be  taken  as  a 
criterion  in  diaj^nosinj.;  the  condition  of  Flat-foot.  The 
arches'  appearance  lus  the  bare  feet  with  the  full  weight  uijon 


5()  FOOT  CARE  AND  SHOE  FITTING 

them  are  placed  in  a  plane  surface  offer  no  means  of  discovering 
the  true  height  of  the  bonjT-  arch. 

The  symptoms  of  flat-foot  are  varied  and  numerous.  Ho\\- 
ever,  the  predominant  one  is  pain  in  the  feet.  This  may  be 
located  indefinitely  in  the  arches  of  the  feet,  heels  or  second- 
arily in  the  calves  of  the  legs,  knees  or  hips.  The  pain  is 
iisually  absent  during  rest  and  is  experienced  only  when  use 
of  the  feet  is  attempted. 

Treatment. 

1.  Complete  rest  for  a  few  days. 

2.  Alternately  immersing  the  feet  in  hot  and  cold  water. 

3.  Correct  walking  posture;  the  feet  parallel  in  standing: 
and  walking. 

4.  Feet  measured  and  shoes  fitted. 

5.  Foot  exercises. 

6.  Strapping  of  the  feet  Avhich  should  be  done  or  supervised 
by  the  Medical  Officer. 

7.  Shoe  alterations  to  shift  the  misplaced  weight  where  ii 
naturally  belongs. 

8.  Arch  supports  should  not  be  worn  for  this  condition  as 
they  tend  to  decrease  the  muscular  power  of  the  soles  of  the 
feet. 

PES  CAVUS 

(Hollow-foot) 

It  is  important  that  this  condition,  heretofore  conspicuously  ' 
absent  from  Foot  Manuals  in  general,  be  discussed  and  brought 
to  the  attention  of  officers  because  of  its  extreme  disabling 
character  when  made  manifest.  In  the  past  the  subject  of 
Pes  planus  (Flat-foot)  has,  in  my  opinion,  been  stressed  en- 
tirely too  much  both  by  manufacturers  of  foot  supports  for 


PES    CAVUS 


,1/ 


pecuniary  reasons  and  by  military  men  because  of  carelessness 
or  inadequate  means  of  examination.  By  this  I  do  not  mean 
to  say'  that  Pes  Planus  (Flat-foot)  is  not  common,  it  is  common; 


Ji.      Lulcral  view  of  nurnial  fuut.      Nulc  cuiivcxily  ut  ai'cu  iiuitkid   x 
denoting  the   integrity  of  the  anterior  arih. 

but  still  other  conditions  exist  and  we  should  watch  for  them 
with  an  unbiased  frame  of  mind.  Pes  Cavus  (Hollow-foot), 
is  just  the  opposite  and  is  a  condition  where  the  longitudinal 
arch  is  hifjher  than  nonnal.     It  has  been  noted  so  frociuently 


S8 


FOOT    (ARE    AND    SHOE    FITTING 


in  foot  examinations  where  a  prcx^ious  diagnosis  of  llat-foot 
by  inspection  had  been  made,  that  it  is  hereby  brought  to 
the  attention  of  officers  as  an  entity. 

This  condition  of  Pes  Cavns,  more  common  than  has  been 


Pig.  22. — Lateral  view  of  abnormal  foot  (fiat-foot).     Note  at  x  the  flattening 
denoting  the  fall  of  the  anterior  arch  usually  associated  with  pes  cavus. 

formerly  thought,  is  characterized  by  a  longitudinal  arch 
higher  than  normal,  poor  muscular  development  of  the  soles 
of  the  feet  and  an  inherent  tendency  on  the  part  of  the  indi- 
vidual to  shift  the  greater  part  of  the  weight  to  the  outer 


PES  CAVtrs  50 

borders  aiid  balls  of  the  feet.  Where  the  arch  has  assumed  a 
great  height  and  the  muscular  development  is  poor  the  weight 
is  not  borne  by  the  outer  borders  of  the  feet  but  is  in  turn 
shifted  entirely  to  the  balls  of  the  feet  (anterior  arches). 
These  latter,  being  unable  to  support  the  weight,  fall.  Asso- 
ciated with  extreme  degrees  of  Pes  Cavus  and  fallen  anterior 
arches  is  the  condition  of  inversion  (prominence  of  inner  side 
of  the  ankle).  For  facility  of  description  and  measurement 
for  treatment  Pes  Cavus  has  been  divided  into  three  degrees 
of  height;  one,  two  and  three.     (See  foot  imprints.) 

The  causes  of  Pes  Cavus  are  usually  ill-fitting  shoes  which, 
cramping  and  binding,  restrict  functional  activity.  The 
assumption  of  great  burden  and  excessive  hiking  also  play  a 
part  in  making  a  condition  worse  the  tendency  of  which  has 
existed  since  birth  due  to  inherent  organic  and  functional 
muscular  deficiencies.  Again,  incorrect  foot  posture  with  the 
toes  turned  in  has  a  part  in  the  causation  of  the  condition. 
The  most  common  causes  from  ill-fitting  shoes  are: 

1.  Shoes  too  short. 

2.  Shoes  too  narrow  across  the  instep  and  ball  of  the  foot. 

3.  Heels  of  shoes  too  high  with  (i)  and  (2). 

4.  Pointed-toe  shoes  (English)  where  the  inner  side  of  the 
.sole  curves  outward. 

5.  Poor  muscular  development  since  l)irlli  with  incorrect 
foot  posture. 

The  symj)toms  are  very  fugacious  and  inconstant.  Many 
complain  of  pain,  which  at  times  becomes  intense  when  weight 
is  borne,  situated  in  the  toes,  ball  of  the  foot  and  longitudinal 
arch.  The  pain  does  not  tend  to  remain  at  one  point  but 
skips  from  place  to  place. 

Treatment:  Where  the  soldier  is  disabled  and  incapacitated 
and  this  condition  is  suspected,  teniporar}-  relief  may  be  ob- 
tained by  placing  a  gauze  or  felt  pad  ^  inch  in  thickness  under 


6o  FOOT  CAKE  AND  SHOE  EITTlNO 

the  longitudinal  arch  and  strappinj:;;  it  in  place  with  adliesive 
tape.  The  thickness  of  the  pad  may  be  increased  or  decreased 
until  relief  is  experienced.  Alternately  immersing  the  feet  in 
hot  and  cold  water-contrast  baths — gives  comfort.  Where 
circumstances  permit,  however,  all  cases  should  be  sent  to  the 
Medical  Officer  for  diagnosis  and  treatment. 

PEDOGRAPHS   (FOOT  IMPRINTS) 

The  method  of  diagnosing  foot  affections  by  a  casual  inspec- 
tion, walking  or  hopping  test,  or  by  palpating  the  foot  has 
been  discarded  as  obsolete  and  inefficient. 

By  the  pedograph  method  five  prominent  signs  are  taken 
into  consideration.     These  signs  are: 

1.  The  pedograph  picture; 

2 .  The  contour  line  of  the  foot ; 

3.  The  height  of  the  scaphoid  bone  (the  keystone  of  the 
longitudinal  arch) ; 

4.  The  muscular  development  of  the  soles  of  the  feet, 
especially  under  the  longitudinal  arch; 

5.  The  presences  or  absence  of  the  juvenile  fat  pad. 

In  taking  the  imprints  the  individual  is  seated  and  extending 
the  leg  the  bare  foot  is  painted  with  an  iron  solution. 
Formula  of  Iron  Solution. 

Tr.  Ferric  chloride 45  c.c. 

Glycerine 5  c.c. 

Alcohol 50  c.c. 

Then  hastily,  the  foot  is  placed  on  paper,  porous  in  charac- 
ter, and  the  individual  is  told  to  place  all  the  weight  on  the  one 
foot.  At  this  point  the  contour  line  is  drawn  by  using  a  pencil 
held  at  right  angles  to  the  plane  surface.  This  contour  line 
demonstrates  the  amount  of  inversion  of  the  ankle  although 


PEDOGRAPHS  6l 

the  muscular  development  of  the  soles  ol'  the  feet  should  be 
watched  as  often  a  heavy  bulging  muscular  la}-er  w-ill  produce 
the  picture  of  inversion.  The  foot  is  then  removed  from  the 
paper  and  the  height  of  the  scaphoid  bone  estimated.  This  is 
done  by  drawing  a  line  from  the  posterior-inferior  aspect  of 
the  inner  malleolus  to  the  first  metatarsophalangeal  joint 
on  its  plantar  aspect.  The  scaphoid  bone  is  usually  felt  one- 
half  inch  below  this  line  which  is  known  as  the  Feiss  Line. 
The  sole  of  the  foot  is  then  palpated  and  the  muscular  develop- 
ment noted  as  thin,  moderate  or  thick.  Presence  of  the  fat 
pad  is  also  sought  for.  All  this  cumulative  data  is  then 
marked  on  the  pedographic  sheet  together  with  the  man's 
name,  rank,  organization,  and  diagnosis. 

A  solution  of  tannic  acid  is  now  applied  to  the  iron  imi)rint 
of  the  foot  which  turns  a  jet  black.     The  formtila  of  the  tannic 

acid  solution  is: — 

• 

Tannic  acid gm.  x  (by  wt.) 

Alcohol 90  c.c. 

The  base  lines  and  au.xiliary  lines  are  now  drawn  on  the 
l^edograph  for  estimation  of  the  disability  if  present. 

The  first  base  line  is  drawn  from  a  point  posterior  to  the 
internal  malleolus  to  the  first  metatarsophalangeal  joint.  The 
contour  line  extending  beyond  this  shows  the  degree  of  inver- 
sion. The  line  of  axis  weight  bearing  is  next  drawn  from  the 
center  of  the  heel  to  a  ]K)int  midway  between  the  first  and 
second  toes.  A  line  0  is  next  drawn  at  right  angles  to  the 
line  of  axis  weight  bearing  from  a  ])oint  i)ostcrior  to  the  heel. 
A  line  M  is  next  drawn  also  at  right  angles  to  the  line,  of  axis 
weight  bearing,  from  the  first  metatarsophalangeal  joint. 
Midway  between  the  line  M  and  0  is  drawn  the  line  of  esti- 
mation, also  at  right  angles  to  the  line  of  axis  weight  bearing. 
The  line  of  estimation  is  then  checked.     One  check  is  i)lace(1 


FOOT    CARE    AND    SHOE    FITTING 


Fig.  23. — Pedograph.     Normal  foot. 


PEDOGRAPHS 


(\^ 


Fici,  2.V/.  —  fcilo^;!'''!'!'-      Normal    fool. 


64 


FOOT  CAKE  AND  SHOE  FITTING 


Fig.  24. — ^Pedograph.     Pes  planus  (flat-foot).     1°. 


PEDOGRAPHS 


65 


Fir..  24rt.      PcloKr.i 


■  I:, 1,1,  I  tl    .1      f..,i(    I  I 


66 


FOOT   CAKE    AND    SHOE   FITTlN"G 


^rr^ 


fUo /^i^Vl-c^ 


Fig.  25. — Pedograph.     Pes  planus  (^flat-foot).     2°. 


PEDOGRAPHS 


67 


/■^/Ua.*t.w>  3 


<^fH 


Pto.  2^n.      Pc<lo(;rai.li.      I'.-,    planus    ((l.ii-fotii ).     j". 


OS 


FOOT  CARE  AND  SHOE  FITTING 


Pig.  26. — Pedograph.     Pes    cavus    (hollow   foot).     1°. 


pi;uoGRAinis 


Cr; 


,„.    2^)rt.— PedoRrapli.      I'<s    lavus    (hollow    foot),     i* 


70 


FOOT   CARE    AND   SHOE    riTTlNG 


>ut/ 


Fig.  27. — Pedograph.     Pes  cavus    (hollow   foot).     2°. 


PEDOGRAPHS 


^^ 


.£>;% 


Vt<..    ZTn.      I'c.l<().;r;iiili.      I'cs   f;iviis    (IkiIIhw    f..fit).      i' 


72 


FOOT    CARE    AND    SHOE    riTTINd 


Fig.  28. — Pedograph.     Pes   cavus    (hollow  foot).     3°. 


PEDOGRAPHS 


7.^ 


FlO.  28a.— P<(l<.;^r;ipli.   I'c-.  c.iviis  (111. 111. w  I. 


74  FOOT    CARE    AND    SHOK    FIl  "I  IXC 

at  the  outer  border  of  the  imprint,  the  other  check  being  placed 
at  the  junction  of  the  Hne  of  estimation  and  the  first  base  line, 
or  if  valgus  exists,  at  the  junction  of  the  line  of  estimation  and 
the  contour  line.  Midway  between  the  two  check  marks  of 
the  line  of  estimation  is  the  point  A^  which  is  normal.  To  the 
inner  side  of  point  A^  the  line  is  divided  into  three  parts  repre- 
senting the  degrees  of  Pes  Planus,  while  to  the  outer  side  of 
the  point  A^  the  line  is  divided  into  three  parts  representing 
the  degrees  of  Pes  Cavus. 

The  above  method,  with  the  exception  of  some  modifications, 
was  originated  and  used  by  Dr.  Edward  A.  Rice  of  Washington, 
D.  C. 

SHOE-FITTING 

Comparison  of  Alarine  Corps  and  Civilian  Lasts 

The  average  individual,  upon  being  measured  and  subse- 
quently fitted,  almost  invariably  asserts  that  the  shoe  given 
him  is  too  large  and  that  in  civilian  life  he  wore  such  and  such 
a  size  shoe  without  suffering  any  inconvenience.  From  this 
he  deducts  that  he  is  the  most  competent  judge  of  his  own  size. 
Furthermore,  he  declares  that  he  can  never  wear  the  size 
fitted  him  and  predicts  with  all  earnestness  the  direst  calamit>' 
that  will  befall  him  on  the  future  march  or  drill.  This  man  is 
a  fair  sample  of  those  who,  ignorant  of  their  own  size  and  of  the 
difference  m  sizes  between  the  Marine  Corps  Lasts  and  Civilian 
Lasts,  endeavor  to  jam  their  feet  into  anything  made  of  leather 
because  of  the  prevailing  style.  This  is  a  result  of  the  hap- 
hazard pernicious  system  of  demand  for  appearance  which  has 
ruined  more  feet  than  can  be  estimated. 

In  this  discussion  many  details  of  difference  between  the 
sizes  of  the  Marine  Corps  and  Civilian  shoes  could  be  enumer- 
ated.    However,  details  are  dry  and  uninteresting;  and  it  is 


SHOE   FITTING 


75 


the  purpose  of  this  Manual  to  ehminate  such  superfluous 
material  where  possible.  Suffice  it  to  say  that  a  Marine 
Corps  shoe  size  7EE  is  far  different  from  the  correspondin>^ 


Fig.   2y. — Anterior  view  <A  iiiariiu-  corps  >iarris(jii  or  dress  shoe. 

civilian  shoe  size;  and  further  tliat  civilian  shoes  made  by 
different  manufacturers  differ  among  themselves.  These 
differences  of  size  may  be  one  of  length  or  width.  It  is  there- 
fore self  apparent  that,  as  the  mihtary  shot-  is  a  shoe  dislinc- 


76 


FOcrr    CARE    AND    STloE    IITTTXC 


live  and  physiologic,  every  man  should  be  correctly  measured 
and  fitted  when  he  first  enters  the  service  if  he  is  to  be  efficient 
and  render  full  value  to  the  go\'ernment. 

The  great  majority  of  recruits  received  in  the  service  for 
training  are  men  who  were  formerly  occupied  in  sedentary 
occui^ations;  exercising  but  little  or  none  at  all  and  riding 


Fig.   30. — Lateral  view  of  marine  corps  garrison  or  dress  shoe. 


whenever  possible  on  street  cars,  automobiles,  bicycles  and 
the  like.  This  universal  aversion  to  walking  is  not  at  all 
startling  and  exceptional  but  typical  of  the  man  of  toda}' 
who  surrounded  by  mechanical  conveyances  of  all  types, 
saves  himself  the  effort  and  takes  the  path  of  least  resistance. 
This  type  of  man  will  usually  have  imdeveloped  relatively 
weak  feet.  Now  supply  this  individual  w^ith  shoes  the  sizes 
of  which  have  been  selected  haphazardly  and  he  will  stand 


CAUSES    OF    MISFITS 


77 


an  excellent  chance  of  having  feet  which  are  ruined  organically 
and  functionally  before  he  leaves  the  training  camp  or  is  sent 
back  from  the  firing  line. 

Then  there  is  that  other  type  of  individual  who  has  practi- 
cally earned  his  livelihood  by  constant  use  of  the  feet.  This 
individual  usually  has  well  formed,  well  developed,  strong 
feet.  These  feet  one  would  call  "good  feet."  Literally, 
throw  shoes  at  this  man,  or  rilldw  him  io  ^olc't  bi<  ^h^c^  i^■(^u^ 


I'^iG.  31. — Sole  of  marine  corps  garrison  or  urcss  shoo. 


the  pile,  and  those  good  feet  will  not  last  long  under  the  stress 
and  strain  of  military  life.  It  requires  no  mental  effort  to 
readily  jpercei\'e  that  no  matter  whether  a  man  enters  the 
service  with  well  or  badly  developed  feet  the  end  result  is 
always  the  same  if  care  is  not  taken  tt)  mertsure  his  feet  and 
fit  shoes  correctly. 

Causes  of  Misfits. 

In  the  past  when  large  numbers  of  men  arrived  suddenly  at 
a  concentration  or  training  camp  aiul  ininicdjal  c  out  fitting  was 


78 


FOOT    CARE    AXD    SHOE    FITTING 


imperative,  commissary  otTiccrs  and  their  assistants  often 
allowed  the  recruit  to  specify  the  size  shoe  he  wore  and  in 
some  instances  pennitted  him  to  select  his  shoes  from  a  pile. 
Such  an  uns^^stematic  procedure  necessarily  resulted  in  a 
large  number  of  men  receiving  ill-fitting  shoes  with  subsequent 
foot  disability.  Fortunately  for  the  efficiency  of  our  armed 
forces  such  an  antiquated,  obsolete  measure  has  been  discarded. 

Consideration  of  the  Ball  Points  in  Fitting. 

Where  the  first  metatarsal  and  fifth  metatarsal  bones  join 
the  higher  and  larger  bones  of  the  ankle  proper  or  instep 
there    are   located   points    called   the    "ball-points."     These 


points  for  the  sake  of  convenience  in  description  and  according 
to  size  may  be  designated  as  the  primary  and  secondary 
"ball-points."  The  primary  or  large  "ball-point"  is  located 
on  the  inner  side  of  the  foot  back  of  the  big  toe  where  a  promi- 
nent protruding  eminence  is,  seen.  The  secondary  or  small 
"ball-point"  is  located  on  the  outer  side  of  the  foot  back  of 
the  little  toe  where  a  protruding  but  less  prominent  point  is 


SHOE   FITTING  7() 

noted.  In  locomotion  when  a  step  is  taken,  and  the  heel 
raised  it  must  be  understood  that  both  these  joints  move 
simultaneously. 

In  fitting  a  well-constructed  military  shoe  it  must  be  made 
certain  that  these  two  points  correspond  with  the  "break" 
or  the  ' '  ball-points ' '  of  the  shoe  sole  and  shoe  upper  in  flexion 
of  the  foot.  When  ill-fitting  has  occurred  these  points  may 
be  anterior  or  posterior  to  the  "break"  with  evil  results. 
Also  where  the  "ball-points"  of  the  feet  and  shoes  fail  to  coin- 
cide exactly  there  is  a  loss  of  gripping  or  propelling  power 
directed  backward  to  shove  the  weight  borne  forward. 

SHOE -FITTING 

Consideration  of  the  Variation  Between  the 
Left  and  Right  Foot 

The  difference  in  the  general  characteristics  of  indix-idual 
men's  feet  and  between  different  individuals  is  striking!)- 
ap})arent  when  measuring  and  fitting  is  ]:)ractiscd.  The  i)oints 
of  difference  are  not  merely  width  and  length  Ijut  involve 
multiple  minor  parts  which  together  form  a  proposition  of 
which  some  cognizance  should  alwaj's  be  taken.  In  discussing 
the  similarity  of  people's  features  we  always  say  there  is 
"something"  about  him  or  her  that  is  familiar  but  cannot, 
definitely  say.  We  cannot  definitely  say  because  our  casual 
inspection  is  not  complete  enough.  Corres])ondingly  there 
is  that  "something"  about  the  feet  which  collectively  make 
a  great  difference  and  j^resents  obstacles  which  must  be  over- 
come if  accurate  measuring  and  fitting  is  to  be  practised. 
These  differences  between  the  feet  may  be  stated  to  consist 
essentially  in  the  posture  of  the  feet  causing  the  ankle  joint 
to  be  deviated  inwards  or  outwards;  the  slope  of  the  toes 
backwards  from   the  great   toe  presenting,   according   to  the 


8o 


FOOT   CARE    AND    SHOE    FITTING 


Lateral  vie^ 


Anterior  view. 
Fig.  33. — Xewly  designed  dress  shoe   U.  S.   Marine  Corps. 


SHOE    FITTING  8 1 

length  of  the  toes  either  a  pointed  or  square  front;  one  may 
be  thin,  bony  and  devoid  of  extensive  muscular  development 
while  the  other  may  be  fat,  well  padded  in  the  heel,  sole  and 
around  the  joints  and  very  much  thicker  through  any  given 
part  than  the  other.  Again  the  heights  of  the  arches  both 
anterior  and  longitudinal  differ;  and  there  may  be  a  great 
difference  in  the  distance  from  the  back  of  the  heel  bone  to  the 
metatarsals  in  one  individual's  feet  and  the  distance  between 
the  same  points  in  another's.  The  distance  mentioned — from 
the  back  of  the  heel  bone  to  the  metatarsals — is  of  great  im- 
portance in  fitting  as  it  fixes  the  location  of  the  primary  and 
secondary  ball-points. 

In  investigations  conducted  in  the  Army  Concentration 
Camps  it  was  found  that  in  60  per  cent,  of  the  enlisted  men's 
feet  the  left  foot  was  larger  than  the  right.  In  some  cases 
this  difference  equalled  two  full  sizes.  Such  findings  as  this 
suggest  food  for  thought.  However,  even  with  this  great 
variation  in  some  cases  there  will  not  result  any  mistakes  in 
fitting  either  foot  too  short,  as  the  Resco  Marine  Corps  Fitting 
vSystem  requires  that  each  foot  shall  l)e  measured  and  the 
larger  foot  ser\"e  as  the  index  of  size. 

The  correctly  fitted  shoe  must  allow  all  ])arts  of  the  foot  to 
function  unrestricted  and  unhampered  by  any  impediments. 
The  parts  of  the  foot  which  are  important  to  consider  in 
regard  to  the  degree  of  fimctionability  when  a  shoe  is  fitted 
are  the  following : 

1.  The  anterior  and  longitudinal  arches. 

2.  Expansion  of  the  foot  sidcwise  and  lengthwi.se. 

,^.  The  "Tripod" — the  principal  points  of  locomotion  and 
weight  bearing — must  be  considered  and  shoes  fitted  so  that 
it  is  allowed  to  spread  apart  and  afford  the  maximum  bearing 
surface.     (See  Anatomy  and  Physiology  of  the  Foot.) 


82  FOOT  CARE  AND  SHOE  irniNG 

SHOE-FITTING 

When  the  present  system  was  introduced  abundant  oppor- 
tunity was  offered  to  study  the  psychology  of  the  individual 
in  regard  to  the  shoe  question.  Upon  a  careful  investigation 
at  this  camp  (Quantico,  Va.),  concurring  with  similar  investi- 
gations at  different  camps  throughout  the  country  the  follow- 
ing characteristic  points  of  the  recruit  were  noted: 

1.  An  inherent  reluctance  of  the  recruit  to  cooperate  and  to 
accept  "something  that  was  new"  as  conclusive  evidence. 

2.  Personal  vanity  played  a  great  part.  Feet  were  often 
jammed  in  shoes  one  to  one  and  a  half  sizes  too  small  for  them. 

3 .  Absolute  ignorance  of  his  own  shoe  size. 

4.  Ignorance  of  the  fact  that  fitting  must  be  practised  with 
the  point  in  view  that  the  feet  expand  due  to  burdens  borne 
and  subsequent  development  from  training. 

5.  Ignorance  of  the  difference  between  the  Marine  Corps 
(MilitarjO  Last  and  the  Civilian  Last. 

6.  Ignorance  of  the  corresponding  sock  size. 

The  system  as  used  at  present  is  not  infallible.  The  detail 
of  men  engaged  in  the  work  must  be  previously  trained;  show 
an  esprit  of  cooperation ;  care  for  and  note  constantly  the  con- 
dition of  the  machine;  work  with  speed  but  not  unnecessary 
haste;  work  accurately  and  demonstrate  good  judgment. 

In  measuring  the  feet  and  fitting  large  members  of  men  the 
following  deviations  of  shoes  from  the  accepted  standard  were 
noted: 

1.  Shoes  too  short. 

2.  Shoes  too  narrow.' 

Although  shoes  were  sometimes  found  too  large  either  in 
width  or  length  this  class  was  decidedly  in  the  minority. 


SHOE    FITTING 


83 


SHOE-FITTING 

Resco  ^Marine  Corps  Shoe-fitting  System 

The  two  devices  used  in  this  shoe-fitting  system  count  for 
simplicity  of  operation  and  facility  in  measuring  and  fitting 
large  numbers  of  men  in  the  least  possible  amount  of  time. 
One  device — the  foot  measuring  machine — follows  roughly  the 


I'll,.  34. — Resco  marine  corps  foot  measurinR  device. 

conl(jur  line  of  the  bottom  of  the  adult  human  foot  but  is 
larger.  This  machine  is  of  cast  metal  and  has  the  heel  jKJsition 
elevated  to  a  correct  height  for  positioning  thehuman  heel  when 
the  foot  is  being  measured  for  the  Marine  Corps  Shoe.  A 
composite  of  the  angles  of  the  inner-soles  and  lasts  of  all 
Marine  Corps  sizes  in  the  Marine  (^)rps  size  range  dctcmiincs 
the  angle  at  which  the  side  wings  arc  set.  The  operation  and 
adjustment  of  the  small  pointer  on  the  width  scale  moved  by 


84  Four    CAKE    AND    SHOE    TITTING 

the  spreading  side  wings  has  been  thoroughly  worked  out. 
This  machine  essentially  translates  the  foot  length  and  width 
into  the  shoe  size  length  and  width. 

The  second  device — the  shoe-fitting  device — consists  of  a  set 
of  thin  metal  blades  each  possessing  a  metal  knob  one-half 
inch  thick  on  one  end.     The  lengths  of  these  blades  respect- 


FiG.  35. — -Resco  marine  corps  shoe  fitting  devices.     Sizes  corresponding  to 
shoe  lengths  indicated. 

ively  corresponds  with  a  shoe  length  which  they  verify  after 
the  foot  has  been  measured  in  the  foot  measuring  machine. 

A  study  of  the  illustrations  accompanying  this  section  will 
readily  make  clear  the  construction  and  operation  of  these 
devices. 

Although  the  great  majority  of  shoe  wearing  people  have 
not  nonnal  feet  according  to  the  classic  standard  certain 
reser\'ations  are  made  and  this  measuring  machine  is  con- 
structed for  the  great  average  of  supposedly  normal  feet 
according  to  the  standards  of  to-day. 


MEASURING    THE    FOOT  85 

In  attempting  to  measure  markedly  abnormal  feet  accuracy 
is  sacrificed.  For  ever}'  established  last  there  is  a  type  of 
machine,  e.g.,  the  Marine  Corps,  Navy  and  Army. 

PROCEDURE  IN  MEASURING  THE  FOOT 

The  individual  removes  his  old  shoes,  puis  on  his  Marine 
Corps  Pack,  holds  his  rifle  and  mounting  the  measuring  plat- 
form sets  his  stockinged  foot  onto  the  base  of  the  machine 
making  certain  that  the  heel  fits  snugly  against  the  curved 
block  at  the  back.  At  this  time  the  measurer  notes  carefully 
whether  the  center  of  the  foot  is  in  the  center  of  the  machine. 
To  do  this  he  imagines  a  line  through  the  center  of  the  foot 
from  the  heel  to  the  toe  and  makes  this  line  correspond  with 
a  like  line  in  the  bottom  of  the  machine. 

The  wings  at  the  sides  are  then  released  and  ]jermitlcd  lu 
press  tightly  against  the  sides  of  the  foot.  The  plunger  on  the 
front  of  the  machine  is  then  ]M-esscd  Ijackwards  until  it  touches 
the  end  of  the  foot.  Thus  the  width  and  length  indicators  are 
^et.     However,  this  is  not  final. 

The  person  being  measured  is  then  requested  U)  balance  on 
the  foot  being  measured  by  resting  the  hand  against  an  over- 
head support  and  told  to  raise  the  heel  onc-fourlli  to  lialf  an 
inch  placing  all  the  superimposed  weight  on  the  ball  of  the 
the  foot.  This  ri.sing  simulates  locomotion;  and  since  he  is 
bearing  all  the  weight  he  usually  bears  on  the  march  the  act 
will  cause  the  same  expansion  of  the  foot  length  and  sidewise. 

Upon  this  act  of  rising  there  is  a  resultant  s])read  of  the  foot; 
a  pushing  of  the  plunger  forward;  and  he  wings  laterally 
indicating  automatically  the  correct  shoe  length  and  width. 

The  inflication  f)f  the  shoe  length  is  always  positive.  This 
is  not  so,  however,  with  the  shoe  width.  As  the  person  raises 
the  Jieel  up  and  down  the  width  indicator  will  sometimes  be 


86 


FOOT  CARE  AND  SHOE  FITTING 


seen  to  waver  back  and  forth.  The  measurer  noting  this 
takes  the  middle  mark  between  the  extensive  points  touched 
by  the  width  indicator  as  the  correct  width. 

For  instance  if  the  pointer  vacillates  between  width  E  and 
width  F  the  correct  width  for  the  shoes  would  be  a  width  EE. 
Wherever  doubt  is  entertained  as  to  the  exact  j^oints  of  width 


Pig.  36. — Foot  being  measured  in  Resco  marine  corps  foot  measuring  device. 

and  length  is  always  best  to  select  the  greater  length  and  nar- 
row width.  vSo  simple  is  the  indication  of  the  size  that  the 
interpretation  is  made  quickly  and  accurately  which  counts 
for  efficiency  in  measuring. 

In  the  U.  S.  Army  Special  Regulations  No.  28  complete 
instructions  for  using  the  machine  are  given.  They  are  as 
follows : 

(a)  After  taking  the  machine  from  its  box,  open  it  widely 
by  moving  the  lever  as  far  front  as  possible  and  pulling  -out 


VERIFYING    THE    SIZE  87 

the  plunger  as  far  as  it  will  go.     The  machine  is  now  ready 
for  use. 

(6)  Have  the  man  put  his  foot  in  the  machine  and  stand  with 
all  his  weight.  The  heel  should  rest  firmly  against  the  heel 
block.  It  is  important  that  the  foot  should  rest  in  the  exact 
center  of  the  machine. 

(c)  Release  the  lever  which  operates  the  width  indicator, 
and  push  the  plunger  until  the  plate  touches  the  toe.  Do 
not  touch  the  plunger  again  while  the  foot  is  in  the  machine. 
Make  sure  that  the  metal  side  pieces  touch  the  toe  joints. 

(d)  Then  let  the  man  throw  his  entire  weight  on  the  ball 
of  his  foot,  raising  the  heel  slightly. 

(e)  The  width  is  automatically  registered  by  the  arrow  as 
the  arrow  wavers,  following  the  action  of  the  heel  up  and  down, 
take  the  average  of  the  extremes. 

(Example.  If  the  arrow  wavers  from  width  "6"  use  width 
"c")  The  correct  size  of  the  shoe  is  indicated  by  the  pointer 
on  the  plunger  on  the  right-hand  scale. 

(/)  Measure  the  other  foot  in  the  same  manner  and  if  there 
should  be  a  difference  select  size  to  fit  the  longer  foot  and  the 
narrower  width. 

(g)  Oil  the  slide  under  the  device  occasionally. 

Note. — Verify  the  length  selected  by  testing  with  shoe-fit- 
ting device. 

SHOE-FITTING 

Verifying  the  Size  and  Fitting  the  Shoe 

In  this  final  and  most  important  act  the  fitting  device  is 
used  to  verify  the  size  of  shoe  length  as  indicated  by  the  foot 
measuring  machine.  Width  is  detcnnincd  from  the  mea.surc- 
mcnts  of  the  measuring  machine  and  is  not  demonstrated  by 
the  fitting  device. 


88 


FOOT   CARE    AND    SHOE    FITTING 


VERIFYING    THE    SIZE  89 

The  shoe-fitting  devices,  as  previously  described,  are  thin 
metal  blades  each  one  of  which  possesses  a  metal  knob  on  one 
end;  and  corresponding  to  a  shoe  length,  is  so  marked,  for 
example,  7,  7}'^,  8  and  so  on. 

The  device,  corresponding  to  the  shoe  length  as  measured,  is 
inserted  into  the  shoe  cavity;  the  knob  end  slipping  into  the  toe 
cavity  and  pressing  against  the  leather  of  the  end  of  the  shoe, 
while  the  other  end  of  the  device  presses  against  the  heel. 
The  blade  of  the  device  being  flexible  readily  conforms  to  the 
curvature  of  the  arch  and  lies  fiat  and  snugly  on  top  of  the 
insole. 

Both  shoes  being  thus  treated,  they  are  laced  firmly  and 
snugly ;  and  walking  is  done  back  and  forth  on  a  level  surface,  up 
a  flight  of  staris  to  a  level  platform  and  do\\Ti  a  elevated  in- 
cline. This  walking  and  stamping  on  plantigrade  surfaces 
simulates  the  conditions  of  marching  and  serves  as  an  index 
of  the  foot  expansion  in  the  service  shoe  bearing  the  super- 
imposed weight  of  the  body  and  equipment.  The  foot  thus 
being  made  to  expand  sidewise  and  lengthwise  to  its  maximum 
a  very  clear  idea  is  obtained  of  the  shoe  fit. 

The  person  being  measured  should  be  able  to  thus  walk 
without  the  toes  jamming  against  the  knob  to  such  an  extent 
that  discomfort  and  pain  is  experienced  if  the  measurer  has 
been  accurate  in  his  estimations.  Merely  touching  the  device 
is  not  considered.  Actual  discomfort  must  be  produced  be- 
fore the  size  of  shoe  is  changed.  From  this  it  can  be  readily 
seen  and  appreciated  that  where  discomfort  is  not  produced 
by  the  toes  jamming  there  is  suflicient  space  allowed  for  toe 
action  when  the  blade  and  knob  are  removed.  Such  is  the 
purpose  of  the  device. 

It  has  been  found  that  cooperation  of  the  person  is  essential 
and  during  the  process  of  "trying  out"  the  shoe  by  walking, 
standard  questions  are  asked  by  the  fitter  who  bears  in  mind 


90 


FOOT  CARE  AND  SHOE  FITTING 


Fig.  38. — Resco  marine  corps  shoe  fitting  device  and  foot  in  the  shoe  cavity. 
(X-ray  photograph.) 


VERIFYING    THE    SIZE  9 1 

the  important  parts  of  the  shoe  which  must  fit  correctly. 
Such  questions  are:  "Do  your  toes  touch  the  knob?"  "If 
so  is  discomfort  or  pain  experienced?"  "Does  your  foot 
sHde  forward  in  the  shoe?"  "Is  the  upper  too  loose?"  "How 
does  the  shoe  feel  across  the  toes  and  instep?"  This,  in 
addition  to  the  mechanical  devices,  is  conducive  to  accurate 
and  conclusive  results  as  found  by  extensive  practice  on  this 
station.     (Quantico,  Va.) 

If  the  length  is  correct,  which  it  shall  be  if  the  procedure 
described  is  carried  out,  there  shall  not  only  be  comfort  but 
also  the  ball-points  of  the  foot  will  be  exactly  opposite  the 
ball-points  of  the  shoe  and  thus  the  two  will  move  synchro- 
nously in  locomotion. 

The  correct  use  of  the  shoe-fitting  device  has  practically 
eliminated  the  old  fault  of  short  shoe  sizes.  However,  mis- 
takes may  be  made  if  judgment  is  not  practised.  Especialh" 
.so,  where  the  length  is  correct,  but  the  heel  of  the  foot  abnor- 
mally narrow  and  therefore  not  gripped  by  the  shoe,  the  foot 
slides  forward  in  the  shoe  and  presses  against  the  knob.  This 
condition  will  also  ha])pen  if  the  shoe  is  too  wide. 

Width  if  not  accurately  determined  by  the  mea.suring  ma- 
chine must  be  done  by  hand.  The  person  faces  the  fitter 
who  gra.sps  the  leather  back  of  the  toe  cap  with  the  index-finger 
and  thumb.  A  faint  movement  of  the  leather  .should  be 
detected  by  the  gripping  fingers  if  the  width  size  is  correct. 
Where  a  distinct  ridge  of  leather  is  picked  up,  the  inference  is 
that  the  width  is  too  large,  and  conversely,  if  no  movement  of 
the  leather  is  detected  the  width  is  too  .small.  In  estimating 
width  much  depends  on  the  training  of  the  fitter  and  his  judg- 
ment. However,  in  addition  to  the  above,  the  comfort  of 
lite  individual  is  considered  and  the  question  is  asked  whether 
the  toes  are  pressed  upon  tightly  or  the  shoe  is  too  loose  oxer 
this  particular  part. 


92 


FOOT   CARE    AND    SHOE   FITTING 


n  ARMY  x:5^=Sp^T>,». 

I      I  NAVY  "^ 


^M    MARINE 

■  COMMON  TO  ALL 


Fig.  39. — Outline  of  sole  of  composite  last  suggested  by  Mr    E    J     Bliss 

Boston,  Mass. 


THE   FITTING   QUARTERS  93 

The  Army  Special  Regulation  No.  28  on  the  use  of  the  shoe- 
fitting  devices  are  as  follows: 

(a)  Select  from  the  several  meastuing  devices  in  the  set  the 
one  marked  mth  the  size  or  half-size  corresponding  with  the 
shoes  to  be  tried  on. 

(6)  Insert  the  knob  end  of  the  device  into  the  toe  of  the 
shoe,  springing  the  other  end  of  device  down  to  the  inner  sole, 
against  the  counter. 

(c)  The  middle  of  the  flat  spring  piece  will  lie  flat  with 
slight  pressure  of  the  foot. 

(d)  If  the  soldier,  with  pack  and  rifle  on  his  back,  can 
without  discomfort  pace  back  and  forth  in  shoes  with  device 
inserted,  the  shoes  will  be  sufficiently  long  to  allow — for  foot- 
expansion  when  the  device  is  withdrawn. 

Note. — The  majority  in  every  case  pass  satisfactory  the 
above  described  test. 

SHOE-FITTING 

Measuring  and  Fitting  Men  at  the  Barracks  (3000  Men 

and  Over.) 

(a)  The  Fitting  Quarters. 

The  fitting  quarters  should  be  centrally  situated  or  as  near 
so  as  convenient  in  order  that  the  least  possible  time  will  be 
taken  by  the  men  in  passing  to  and  from  the  building.  The 
size  of  building  recommended,  and  used  with  perfect  satis- 
faction at  this  Post  (Quantico,  Va.)  is  the  ordinary  type  of 
barrack  building  ninety-eight  feet  in  length  and  nineten  feet 
and  four-sixteenths  of  an  inch  in  width.  This  building  is 
divided  into  three  rooms,  the  waiting,  measuring  and  fitting 
rooms,  by  partitions  seven  feet  and  four-sixteenths  of  an  inch 
in  height  fitted  with  doors.  These  partitions  extend  width- 
wise  at  right  angles  to  the  long  axis  of  the  building.     There  is 


94 


FOOT   CARE    AND    SHOE    FITTING 


UJ  cQ  a  Z  aio  t- oo  <o  lu 


<rz 

to 

UJ 

QUANT  CQW 

OICATE  ROUTE  OF  ME 

COz 

vo 

r*^^ 

^i 

1— Gc:< 

1 

U-l 

U-JZ 

O 

^^  _l 

CO 

ARI 

TTED 

Sg 

cr 

UJ 

Q 
cr 
o 

UJ 

RDERLY 

EASURERS 

VERSEER 

rOCKMEN 

TTER 

o:  O  Z  O  in  u. 

<  QQO  QuJ  "- 

THE    FITTING   QUARTERS 


95 


3^    IN. 


thus  provided  three  rooms  of  ample  size  through  which  men 
pass  in  a  continuous  stream;  entering  at  one  end  of  the  building 
,and  passing  out  at  the  other.     (See  drawing.) 

The  waiting  room  at  one  end 
of  the  building  is  thirty-one  feet 
and  six-sixteenths  of  an  inch  long. 
It  is  fitted  with  as  many  ordinary 
mess  benches  as  it  will  accom- 
modate plus  the  recorder's  table 
at  the  door  leading  into  the 
measuring  room.  The  table  has 
legs  thirty  inches  high  and  a  top 
thirty-two  inches  by  thirty-two 
inches.     (See  drawing.) 

The  measuring  room  at  the  center  of  the  building  is  thirty- 
five  feet  in  length  and  is  fitted  with  the  measuring  table  which 
is  thirty  inches  high  and  possesses  a  top  twenty-one  by  ten 


a 


41. — Recorder's  table. 


/4 Jl     F£t» — »\ 

Fig.  42. — Measuring  platform. 

feet.  (See  drawing.)  On  one  end  and  a  side  arc  steps  to  the 
floor.  On  this  table  are  set  the  Resco  Marine  Corps  Fool 
Measuring  Machines  six  in  number.  Mess  benches  arc  pro- 
vided for  the  measurers.     (See  drawing.) 


96  FOOT    CAKE    AND    SHOE   PITTrNTG 

The  fitting  room  at  the  other  end  of  the  building  is  fitted 
with  a  shoe  rack  on  one  side,  mess  benches,  and  a  testing  incline 
on  the  other  side.  The  shoe  rack  contains  one  hundred  and 
forty-four  pigeon  holes  and  each  pigeon  hole  is  eight  inches  by 
six  inches  and  is  twelve  inches  deep.  (See  Fig.  45.)  It  is 
very  necessary  that  one  end  of  the  rack  be  equipped  wdth 
shelves  of  the  same  depth  as  the  pigeon  holes.  Swinging 
doors,  fastened  securely  with  locks  add  to  the  security  of  the 
cabinet.  Kept  on  hand  in  the  rack  at  all  times  are  one 
hundred  and  forty-five  pairs  of  shoes;  the  sizes  most  common 
being  emphasized.  The  sizes  kept  and  the  number  of  pairs 
of  each  size  are  as  follows : 

Pair  Pair 

5C y I  7EE 2 

5E I  7F 2 

5EE I  7KB I 

5F I  7MC 4 

5KC 2  7KD 2 

5>^EE 2  7KE 3 

5HF 2  7>2EE 2 

6B I  7MF 2 

6C 2  8B 2 

6D I  8C , 3 

6E 3  8D 4 

6EE I  8E 3 

6F 2  8EE I 

6}iB I  8F I 

eViC. 3  SViB I 

6KD 3  8MC 3 

63^E I  8HD 3 

6>^EE I  SHE 3 

63.^F 2  8MEE I 

7B I  8HF 2 

7C 3  9B 2 

7D 2  9C 2 

7E 4  9D 3 


FITTING    PLATFORM 


97 


Pair 
3 

3 
3 
I 

2 

3 


9E 

9EE 

9F 

9>2B 

9KC 

9>^D 

93'2E 2 

9>^EE 2 

9>2F 2 

loB 

loC 

loD 

loE 

loEE 

loF 

I0>2B 

io>^C 

loj-aD 

iCaE 


Pair 

0>^EE 2 

o>^F 

iB 

iC 

iD 

lE 

lEE 

iF 

13-26 

O^C 

i>^D 

iKE 

i>2EE 

I3-2F 

2B 

2C 

2D 

2E 


The  testing  incline  consists  of  a  horizontal  platform  thirty- 
iwo  by  twenty-five  inches  equipped  with  legs  thirty  inches 
in  height.     The  incline  leading  from  one  side  of  the  platform 


p* 

^ — i 

0 

Fig.  4.}.— Fitting  platform  and  test  incline. 

to  the  floor  is  nine  feet  in  length  with  wooden  cleats  on  its 
upper  surface  at  intervals  of  three  inches.  (Jn  the  opposite 
side  of  the  platfomi  are  steps  which  arc  twenty-five  inches 
from  the  table  to  the  floor.     (See  drawing.) 

7 


98  FOOT  CARE  AND  SHOE  FITTING 

SHOE -FITTING 

General  Procedure  of  Fitting 

The  company  commander  being  responsible  for  the  con- 
dition of  the  shoes  and  proper  fitting  of  his  command  takes 
the  initiative  in  arranging  an  engagement  with  the  Medical 
Officer  in  charge  of  the  measuring  and  fitting.  Men  who  have 
just  entered  the  service,  those  who  have  completed  the  train- 
ing and  those  who  are  in  need  of  new  footwear  are  sent  to  the 
fitting  quarters. 

All  the  men  upon  arriving  at  the  fitting  quarters  should 
have  the  pack  and  rifle,  and  be  accompanied  by  the  company 
commander  or  his  representative.  Entering  the  waiting 
room — the  number  determined  by  the  recorder — everyone  is 
ordered  to  remove  the  leggings  and  shoes.  This  done,  men 
as  needed  are  called  by  the  orderly  who  stands  at  the  door 
leading  from  the  waiting  room  to  the  measuring  room;  and 
as  each  man  passes  the  recorder  a  printed  "Deformity  and 
Recording  Slip"  is  made  out.  The  recorder  writes  the  man's 
name,  age,  organization,  date,  time  in  service  and  record  of 
present  size  of  shoe.  (See  facsimile  of  slip.)  The  orderly 
closely  observes  the  number  of  men  in  the  measuring  room  and 
prevents  overcrowding  of  the  same  by  only  calling  a  man  from 
the  waiting  room  when  he  sees  one  step  from  the  measuring 
table  to  the  fitting  room. 

Entering  the  measuring  room  the  table  is  mounted  by  the 
person  to  be  measured  and  the  slip  handed  to  the  measurer. 
Deformities  are  noted  and  recorded  if  it  is  a  first  meastirement ; 
and  each  foot  being  accurately  measured,  as  before  described, 
the  measurements  as  made  are  noted  on  the  slip  under  the 
heading  of  "Estimated  Size  of  Shoe."  The  slip  is  returned 
to  the  man  and  he  passes  on  into  the  fitting  room.  Here 
again  a  check  is  maintained  to  prevent  overcrowding  in  the 


GENERAL   PROCEDURE    OF   FITTING 


99 


3 

o 


a.  I  •<;  "  £ac! 


lOO  FOOT  CARE  AND  SHOE  FITTING 

person  of  the  shoe  overseer  who  allows  only  the  number  of 
men  to  enter  the  fitting  room  equal  to  the  number  that  passes 
out. 

Entering  the  fitting  room  the  slip  is  given  to  one  of  the 
stockmen  who  notes  the  "Estimated  Size  of  Shoe"  and  pro- 
cures from  the  rack  a  corresponding  size  of  shoes  containing 
in  the  shoe  cavities  the  Resco  Marine  Corps  Shoe  Fitting 
Devices.     The  slip  is  returned  to  the  man  by  the  stockman. 

The  fitting  platform  is  then  mounted,  and  facing  the  fitter 
the  slip  is  handed  to  the  latter  who  notes  the  size  svipplied  and 
examines  the  width  of  the  shoe.  The  company  officer  stands 
beside  the  fitter  to  see  that  all  his  men  are  fitted  satisfactorily. 
Walking  is  then  practised  on  the  testing  incline  to  reveal  any 
deficiencies  in  length.  If  the  test  is  satisfactory  and  the  size 
correct  the  fitter  retains  the  slip  and  records  the  size  as  the 
"Fitted  Size."  "The  vSize  of  Sock"  is  recorded  by  reference 
to  the  Sock  Scale.  (See  page  24.)  The  man  is  then  told  to 
remove  the  shoes,  give  them  to  one  of  the  stockmen,  place  on 
his  own  and  pass  out  by  the  shoe  overseer  who  takes  especial 
care  that  no  fitted  shoes  leave  the  fitting  room  intentionally  or 
otherwise. 

The  completed  fitting  slips  are  signed  or  stamped  by  the 
Medical  Officer  and  sent  to  Company'  office  where  the  "Fitted 
Size"  and  "Size  of  Sock"  are  entered  in  the  man's  record 
service  book  by  the  company  clerk.  (Marine  Corps  Orders; 
Ntmiber  42  (Series  191 5)  Dec.  20,  191 5  Paragraph  185  (4)) 
Thereafter  all  shoes  issued  to  the  individual  must  correspond 
with  the  size  entered  in  the  record  service  book.  The  slips 
are  returned  by  the  company  office  to  the  Medical  Officer  in 
charge  of  measuring  and  fitting  for  his  files. 

Following  this  system  at  this  Post  working  an  enlisted 
personnel  of  eight  men,  an  average  of  one  hundred  and  twenty 
men  an  hour  were  accurately  measured  and  fitted. 


MEASURING    AND    FITTING  lOI 

SHOE-FITTING 

Measuring  and  Fitting  Men  at  the  Barracks  or  in  the  F'ield 
(500-3000  Men) 

Fitting  Quarters. 

For  measuring  and  fitting  men  totahng  the  above  numbers 
half  a  barrack  building  the  length  of  which  is  forty-nine  feet 
or  tents  joined  together  so  as  to  equal  the  amount  of  floor 
space  included  in  the  above  will  provide  ample  room  for  all 
purposes.  It  must  be  repeated  again  that  a  central  location 
is  imperative  as  the  time  element  is  very  important.  The 
division  of  the  quarters  into  several  rooms  or  of  the  tents  into 
several  compartments  is  not  absolutely  necessary  just  as  long 
as  the  equipment  is  spaced  correctly  and  the  men  engaged  in 
the  work  are  sufficiently  acquainted  with  the  routine  to  manage 
the  men  systematically  as  they  pass  through. 

The  equipment  necessarily  must  be  of  such  a  size  that  it  will 
be  adaptable  to  the  floor  area  without  undue  overcrowding  and 
consequent  confusion.  Mess  benches,  if  in  the  barracks,  or 
logs  and  similar  material,  if  in  the  field,  will  suffice  as  seats  for 
those  who  remove  the  shoes  and  leggins.  The  recorder's 
table  should  be  of  the  same  size  as  described  in  Chapter  18, 
or  in  the  field  the  top  of  a  barrel,  smooth  top  of  a  stump  box, 
etc.,  can  be  utilized.  A  measuring  table  twenty  by  five  feet 
equipped  with  legs  thirty  inches  high  is  recommended;  the 
plans  to  be  the  same  as  described  for  the  larger  table  in  Chai)- 
ter  1 8  equipped  with  steps.  In  the  field  it  has  been  found  that 
an  improvised  bench,  smooth  topped  large  rock  or  stump  with 
a  sea  box  on  top  makes  a  fairly  good  fitting  platform.  (See 
illustration.  Chapter  20) .  Testing  incline  and  fitting  platfonn 
should  have  same  dimensions  as  mentioned  in  Chapter  18  for 
work  in  the  barracks.  In  the  field  the  testing  incline  can  be 
made  by  placing  two  boards  or  logs  in  position,  the  proximal 


I02 


FOOT   CARE    AND    SHOE   FITTING 


ends  resting  on  the  sea  box  or  its  support  and  the  distal  ends 
on  the  ground.  The  rack  required  for  fitting  five  hundred  to 
three  thousand  men  should  contain  approximately  ninety- 
six  pigeon  holes,  each  pigeon  hole  being  eight  by  six  inches  and 
twelve  inches  deep.  Swinging  doors  fastened  and  held  se- 
curely should  be  added.  Shelves  are  optional  depending  on 
the  amount  of  space.  The  sizes  of  shoes  and  numbers  of 
individual  pairs  required  would  be  approximately  the 
following : 


Pair 
.  I 
.  I 
.  I 
.  I 
.     2 


5C 

5E. 

5EE 

5F 

53-^C 

5MEE 2 

5HF 2 

6B 

6C 

6D 

6E 

6EE 

6F 

6HB 

6MC 

6MD 

6ME 

6HEE 

eyiF 

7B 2 

7C 2 

7D 2 

7E 2 

7EE 2 

7F 2 

7MB I 

7HC 2 


Pair 

7HD 2 

7HE 2 

7HEE 2 

7KF 2 

8B I 

8C 2 

8D 2 

BE 2 

SEE 2 

8F 2 

8KB I 

8MC 3 

8KD 3 

8KE 3 

8HEE I 

8KF 2 

9B I 

9C I 

9D 2 

9E 2 

9EE 2 

9P 2 

93-^6 I 

9KC I 

9MD I 

9KE 2 

9KEE 2 


FITTING   QUARTERS 


103 


Pair 

9>^F 2 

loB I 

loC I 

loD 2 

loE I 

loEE 2 

loF I 

io>^A I 

loHB I 

loKD I 

loHE I 

lO^EE 2 

loHF I 

iiB I 


Pair 


IlC 

IlD.... 
IlE 

iiEE... 
iiMB.. 

iiHC. 

iiHD.. 
ii^E  .. 
iiHEE. 
iiKF.. 

12B 

12C...., 

12D 

12E 


Aboard  ship  the  testing  indine  and  measuring  platform  may 
be  made  by  utiHzing  a  mess  bench  with  one  pair  of  legs  let  down 
in  the  first  instance  and  a  mess  bench  and  sea  box  in  the  latter. 
Other  equipment  as  specified  may  be  made  and  arranged 
according  to  the  discretion  of  the  Medical  Officer. 

Racks  cannot  be  considered  in  the  field.  The  best  arrange- 
ment would  be  to  procure  the  desired  sizes  and  number  of 
pairs  of  shoes  from  the  Quartermaster;  and  placing  a  strip  of 
adhesive  plaster  on  the  heel  marking  the  size  with  ink  arrange 
them  in  parallel  rows  on  the  ground  according  to  size.  The 
sizes  and  number  of  individual  pairs  will  vary  according  to 
the  number  of  men  to  be  fitted.  The  list  complied  in  this 
chapter  is  suitable  for  a  starting  j^oint. 

Fitting  slips  should  be  used  in  the  Barracks  and  the  same 
procedure  carried  out  as  described  in  Chapter  18.  In  the  field 
it  will  be  a  rare  occurrence  if  a  man  is  measured  and  fitted  for 
the  first  time  so  slij^s  will  not  be  so  necessary.  If  required, 
however,  slips  of  ordinary  writing  paper  with  measurements, 
etc.,  may  be  made  out  and  sent  to  the  company  office  for 
entry  in  the  record  service  book. 


I04 


FOOT   CARE    AND    §IIOE    FITTING 


6  //y. 


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FOOT   IN    CrVILLIAN    LAST 


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KiG.  46. — Foot^in    ordinary  civilian    or    so-called    ICnKlish^last.      Note    tin 
lessened  width  and  length  restricting  toe  action.     (A'-ray  photograph  j 


io6 


FOOT  CARE  AND  SHOE  FITTING 


Fig.  47. — Foot  in  marine  corps  last.  Sufficient  length  but  insufficient 
breadth.  Toes,  however,  are  deformed  by  wearing  civilian  lasts.  Note  the 
outward  deviation  of  the  big  toe  (hallus  valgus).     (X-ray  photograph.) 


MAKESHIFT   MEASURING    PLATFORM 


107 


The  personnel  wall  consist  of : 

1.  The  Recorder. 

2.  The  Orderly. 

3.  Two  Measurers. 

4.  The  Shoe  Overseer. 

5.  The  Stockman. 

6.  The  Fitter. 

The  duties  of  these  men  have  been  explained  in  Chapter  18 
so  repetition  is  unnecessary. 

SHOE  FITTING 

Measuring  and  Fitting  Men  in  the  Field  (500  Men  or  Less) 

Measuring  and  fitting  in  the  field  will  sometimes  tax  the 

ingenuity  of  the  Medical  Officer.     However,  it  should  not 

he  difficult  if  he  is  thoroughly  acquainted  with  the  system  as 


Fi(..   48.  -.Makeshift   mcisunriK   plat l'i>riii    (imss  hcmii   ami   si'u   bo.x). 

used  in  the  Barracks.  Being  thus  familiar  with  the  system 
generally,  he  can  devise  many  make'shift  appliances,  arrange 
his  men  correctly  and  do  efficient  work. 

In  the  field  the  greatest  numl)cr  of  fittings  will  be  second  or 


io8 


FOOT   CARE    AND    SHOE    FITTIXG 


Fig.   49. — Marine  fully  equipped  on   makeshift  fitting  platform.     Medical 
officer  is  observing  the  fit. 


MAKESHIFT   TEST   INCLINE 


109 


third  fittings,  where  the  data  for  sizes  will  be  taken  from  the 
record  service  book.  It  is  evident,  then,  that  the  great  bulk 
of  the  work  will  be  devolved  on  thefitters  and  that  the  measurer 
will  have  little  to  do.  It  is  therefore  recommended  that  the 
fitting  space,  where  comparative  seclusion  is  essential,  be 
])laced  under  cover. 

The  general  plan  of  the  measuring  and  fitting  spaces  will 
be  similar  to  those  used  in  the  Barracks.  A  space  of  ground 
two  hundred  and  twenty-five  square  feet  should  be  pegged 
off  with  wooden  pegs.     In  this  space  may  be  placed  logs, 


1-1., 


uKL'siiiiL  LL'Ti  iiicuiK,'  ami  liLliu^  plaUorin  Im  use  111  tin 
posed  of  a  sea  box,  mess  bench  and  two  planks. 


boxes  and  similar  material  for  tliosc  who  Iuin'o  to  remove  the 
shoes  and  socks.  Here  also  will  sit  the  recorder  with  a  bo.x 
upon  which  are  placed  the  record  service  books  of  those  who 
are  to  be  measured  for  the  first  time.  Regulation  fitting  slips 
or  slips  of  writing  paper  may  be  used  to  record  first  measure- 
ments and  fittings. 

Directly  in  front  of  the  waiting  space  is  a  space  equal  in 
area  which  is  also  pegged  off;  this  is  the  measuring  si)ace. 
Here  may  be  placed  a  makeshift  measuring  platform.  (See 
illustration.)     One  pair  of  Resco  Marine  Corps  Foot  Measur- 


} 


no  FOOT   CARE   AND    SHOE    FITTING 

ing  Machines  is  sufficient  for  all  purposes.  There  is  one 
measurer. 

Directly  in  front  of  the  measuring  space  is  the  fitting  space 
equal  in  area  to  each  of  the  other  two  and  under  cover  of 
canvas.  In  this  is  placed  the  makeshift  fitting  platform  and 
test  incline.  Only  the  common  shoe  sizes  should  be  procured 
from  the  Quartermaster  and  each  size  plainly  marked  by 
adhesive  tape  and  ink  on  the  side  of  heel.  The  shoes  may  be 
arranged  in  parallel  rows  on  benches  or  logs  and  replaced  as 
quickly  as  they  are  returned.  The  personnel  of  the  fitting 
space  will  consist  of  one  stockman  and  one  fitter. 

From  this  description  it  can  be  readily  seen  that  the  men 
will  pass  through  the  different  spaces  in  exactly  the  same 
manner  as  in  the  barrack  building. 


APPENDIX 


OLD  ARMY  ORDER 

COVERING    THE    SUBJECT    OF   FOOT-MEASURING 
AND  SHOE-FITTING 

General   Orders  War   Department, 

No.  26.  Washington,  August  16,  1912. 

I .  With  a  veiw  to  increasing  the  marching  capacity  of  troops, 
company  commanders  will  personally  measure  the  feet  and  fit 
the  shoes  of  men  of  their  commands  and  will  be  held  responsi- 
ble that  the  instructions  herein  contained  are  strictly  followed. 

All  measurements  prescribed  herein  will  be  taken  with  the 
soldier  standing  in  bare  feet  and  with  a  40-pound  burden  on  his 
back,  bearing  the  entire  weight  upon  the  foot  to  be  measured. 
Balance  may  be  preserved  by  resting  the  hand  on  a  fixed 
object.  The  measurements  of  the  foot,  which  must  be  taken 
to  make  suitable  preliminary  selection  of  the  shoe  to  try  on. 
are  (a),  the  length;  (6)  the  circumference  around  the  ball. 

To  measure  the  length  the  soldier  will  stand  with  foot  upon 
the  foot  measure,  furnished  by  the  Quartermaster's  Depart- 
ment, fitted  in  a  slot  in  a  board,  the  heel  of  the  soldier  fitting 
snugly  against  the  heel  block.  The  movable  block  will  then 
be  pushed  up  until  it  touches  the  end  of  the  great  toe.  The 
scale  on  the  top  of  the  mea.sure,  which  is  graduated  in  sizes, 
will  then  be  read,  and  the  i;roper  length  of  the  shoe  will  be 
determined,    approximately,    by   adding  2  to  the  reading  of 

111 


112  FOOT    (ARE    AND    SHOE    FITTING 

the  scale;  thus,  if  the  soldier's  foot  scales  63--^,  a  shoe  not 
smaller  than  83-^  should  be  tried  on  first. 

To  take  the  ball  measure,  pass  the  foot  tape,  supplied  by 
the  Quartermaster's  Department,  around  the  foot  at  the 
prominent  tubercle  at  the  base  of  the  great  toe  and  the  promi- 
nent tubercle  at  the  base  of  the  little  toe. 

The  tape  should  lie  closely  to  the  flesh,  but  should  not  be 
so  tight  as  to  compress  it.  Having  taken  the  foregoing  meas- 
urements, the  shoe  best  suited  to  the  foot  will  be  determined 
by  reference  to  Circular  No.  lo.  Quartermaster  General's 
Office,  April  6,  191 2.  For  example,  assume  that  the  circum- 
ference of  the  ball  is  found  to  be  9^^  inches.  In  the  table  on 
page  28  of  the  aforesaid  circular,  under  the  heading  "  Marching 
shoes,"  it  will  be  seen  that  for  a  foot  requiring  an  8}y^  shoe  a 
ball  measurement  of  9^^  inches  corresponds  to  a  D  width. 
The  size  of  shoe  to  try  on  for  actual  fitting  is,  then,  in  this  case 
8HD. 

If  the  ball  measurement  found  as  above  does  not  correspond 
exactly  with  any  ball  measurement  given  in  the  table,  then 
the  narrower  of  the  two  widths  between  which  the  measure- 
ment lies  should  be  selected. 

Beginning  with  the  size  and  width  thus  tentatively  selected, 
shoes  will  be  tried  on  until  a  satisfactory  fit  is  secured.  Correct 
fit  in  waist  and  instep  will  be  determined  experimentally. 
To  determine  the  fact  of  fit  the  shoe  will  be  laced  snugly  and 
the  soldier  with  a  40-pound  burden  upon  his  back  will  again 
throw  his  entire  weight  on  one  foot.  The  officer  will  then 
press  in  the  leather  of  the  shoe  in  front  of  the  toes  to  determine 
the  existence  of  sufficient  vacant  space  in  that  region  to  pre- 
vent toe  injury.  Under  no  circumstances  should  this  vacant 
space  in  front  of  the  great  toe  to  be  less  than  two-thirds  inch ; 
nor  should  there  be  pressure  on  the  top  of  the  toes. 

The  officer  will  then  grasp  with  his  hand  the  leather  of  the 


APPENDIX  113 

shoe  over  the  ball.  As  his  fingers  and  thumb  are  brought 
slowly  together  over  the  leather,  the  shoe  should  feel  snugly- 
filled  without  apparent  tension,  while  the  leather  should  lie 
smoothly  under  the  hand.  If  the  leather  wrinkles  under  the 
grasp  of  the  hand,  the  shoe  is  too  ^vide  and  a  narrower  width 
is  needed;  if  the  leather  seems  tense  and  bulging  and  the  hand 
tends  to  slip  over  easily,  the  shoe  is  too  narrow  and  a  greater 
width  is  necessary. 

It  may  be  necessary  to  try  on  several  pairs  of  shoes  in  this 
manner  before  an  entirely  satisfactory  shoe  is  secured.  A 
record  of  the  proper  size  and  width  of  shoes  as  determined 
above  will  be  kept  as  provided  in  Circular  No.  10,  Quarter- 
master General's  Office,  April  6,  1912. 

Measurements  will  be  taken  and  shoes  will  be  fitted  as 
prescribed  at  least  once  in  each  enlistment  and  the  record  will 
be  changed  from  time  to  time  if  subsequent  fittings  render  a 
change  necessary. 

Sizes  called  for  in  requisitions  will  conform  to  the  record; 
and  the  fact  of  fit  of  shoes  issued  on  such  requisitions  will  be 
personally  verified  in  every  instance  by  company  commanders 
in  the  manner  above  prescribed. 

No  shoes  will  be  issued  to,  or  worn  by.  enlisted  men  while 
on  duty  which  are  not  fitted  in  accordance  with  this  order. 

New  shoes  should  be  adapted  to  the  contours  of  the  feet  as 
soon  as  possible.  Shoe  stretchers,  with  adjustable  knobs,  to 
take  pres.sure  off  painful  corns  and  bunions,  are  issued  by 
the  Quartermaster's  Department. 

All  shoes  should  be  properly  broken  in  before  beginning  a 
march,  but  if  this  is  impracticable,  then  the  following  is 
suggested  but  not  required. 

The  soldier  stands  in  his  new  shoes  in  about  2 3-^  inches  of 
water  for  about  five  minutes  until  the  leather  is  thoroughly 
pliable  and  moist;  he  should  then  walk  for  about  an  hour  on 

8 


114  FOOT  CARE  AND  SHOE  FITTING 

level  surface,  letting  the  shoes  dry  on  his  feet,  to  the  irregu- 
larities of  which  the  leather  is  thus  molded  in  the  same  way 
as  it  was  previously  molded  over  the  shoe  last.  On  taking 
the  shoes  off  a  very  little  neat's-foot  oil  should  be  rubbed 
into  the  leather  to  prevent  its  hardening  and  cracking. 

If  it  is  desired  to  waterproof  the  shoes  at  any  time,  a  con- 
siderable amount  of  neat's-foot  of  should  be  rubbed  into  the 
leather. 

Light  woolen  or  heavy  woolen  socks  will  habitually  be  worn 
for  marching;  the  socks  will  be  large  enough  to  permit  of 
wrinkling.  Darned  socks,  or  socks  with  holes,  will  not  be 
worn  in  marching. 

Company  commanders,  by  frequent  inspections  throughout 
the  year,  will  maintain  the  feet  of  their  men  in  condition  for 
proper  marching.  They  will  cause  the  proper  trimming  of 
nails,  removal  or  paring  of  corns  and  callouses,  relief  of  pain- 
ful bunions,  treatment  of  ingrowing  nails,  and  other  defects, 
sending  serious  cases  to  the  surgeon. 

Before  a  march  is  undertaken  by  foot  troops  company  com- 
manders will  personally  inspect  the  bare  feet  of  their  men. 
While  on  the  march  they  will  personally  see  each  day  that 
their  men  wash  their  feet  as  soon  as  possible  after  reaching 
camp,  prick  and  evacuate  blisters,  and  cover  such  blisters  or 
excoriations  with  zinc  oxide  plaster,  supplied  by  the  Medical 
Department,  applied  hot,  dust  the  feet  with  the  foot  powder 
supplied  by  the  Medical  Department,  and  put  on  clean  socks. 
Hereafter,  an  undue  amount  of  foot  injury  and  disability  from 
shoes  will  be  regarded  as  evidence  of  inefficiency  on  the  part  of 
the  officers  concerned  and  as  causes  for  investigation. 

Post  quartermasters  will  provide  a  place  in  the  quarter- 
master's storehouse  where  shoes  may  be  fitted  for  the  purpose 
of  determining  or  verifying  the  record  required  by  General 
Orders,  No.  48,  War  Department,  191 1.     For  the  purpose  of 


APPENDIX  115 

fitting  they  will  keep  on  hand  at  all  times  a  complete  series  of 
each  size  and  width  of  shoes  furnished  for  issue.  Shoes  of 
this  series  will  be  put  in  stock  and  issued  before  they  become 
unserviceable,  and  will  be  replaced  by  new  shoes,  keeping  the 
series  always  complete.  Company  commanders  will  report 
in  writing  to  the  post  commander  every  instance  of  failure  to 
secure  proper  shoes  for  their  commands  or  to  obtain  proper 
facilities  for  fitting  the  shoes  as  herein  directed.  Post  com- 
manders will  investigate  the  reasons  for  and  be  held  respon- 
sible as  far  as  lies  in  their  power  for  the  rectification  of  such 
deficiencies. 

A  brief  record  of  the  number  of  such  reports  from  company 
commanders  and  the  reason  for  such  deficiencies  will  be  fur- 
nished to  inspectors  at  each  inspection  of  the  post. 

Inspections  conducted  under  the  provisions  of  paragraph 
913,  Army  Regulations,  will  embrace  an  inquiry  into  the  man- 
ner in  which  this  order  has  been  complied  with,  and  the  report 
of  inspections  will  include  a  statement  of  all  instances  of 
failure  on  the  part  of  com])any  commanders  to  secure  proper 
shoes  for  their  commands  and  the  cause  of  such  failure. 

(1856626  R— A.  G.  O.) 

II — A  new  pattern  shoe  has  been  adopted  for  the  service 
which,  when  the  old  stock  shall  have  been  exhausted,  will 
supersede  the  different  patterns  now  on  hand  in  the  Quarter- 
master's Department.  Hereafter,  until  the  old  supply  is 
exhausted,  requisitions  for  shoes  will  be  filled  from  stock  on 
hand,  irrespective  of  pattern  or  finish. 

(1856626  vS— A.G.O.) 

By  order  of  the  Secretary  of  War: 

Leonard  Wood, 
Major  General,  Chief  of  Staff. 
Official : 

Geo.  Andrews, 
Adjutant  General. 


Il6  FOOT   CARE    AND    SHOE    FITTING 

NEW  ARMY  ORDERS 

SPECIAL  REGULATIONS  NO.  28 

TEXT  OF  REVISED  REGULATIONS  APPLYING 
TO  THE  FIT  OF  ENLISTED  MEN'S  SHOES 

Changes 

No.  3.  War  Department, 

Washington,  September  20,   19 18. 

Paragraph  14,  Special  Regulations  No.  28,  Sanitary  Regula- 
tions and  Control  of  Communicable  Diseases,  is  changed,  as 
follows : 

14.  (Changed  by  S.  R.  No.  28,  C.  No.  3,  W.  D.,  19 18). 
Fitting  of  shoes  and  care  of  feet. — With  the  view  of  increasing 
the  marching  capacity  of  troops,  company,  troop,  battery  and 
Detachment  commanders  will  personally  satisfy  themselves 
that  the  men  of  their  commands  have  been  properly  measured 
and  fitted  with  shoes  and  socks,  and  will  be  held  responsible 
that  the  instructions  herein  contained  as  to  care  of  feet  are 
strictly  followed,  and  that  their  men  are  required  to  wear  shoes 
and  socks  properly  fitted. 

Foot-measuring  machines  and  shoe-fitting  devices  will  be 
supplied  by  the  Quartermaster  Corps  in  such  numbers  as  may 
be  needed  at  each  camp  and  garrison  post  in  the  United  States, 
the  Philippines,  Panama  Canal  and  Hawaiian  Departments,  for 
use  in  fitting  shoes.  The  use  of  the  measuring  machines  and 
the  fitting  devices  is  to  be  under  the  supervision  of  the  unit 
supply  officers  and  supply  officers  of  depot  brigades,  to  whose 
offices  will  be  attached  personnel  properly  instructed  in  meas- 
uring- and  shoe-fitting  devices  will  be  kept  by  company,  troop, 
battery,  and  detachment  commanders. 

Directions  for  operating  "Resco"  foot-measuring  machine: 

(a)  After  taking  the  machine  from  its  box,  open  it  wide  by 


APPENDIX  117 

loving  the  lever  as  far  front  as  possible  and  pulling  out  the 
lunger  as  far  as  it  will  go.  The  machine  is  now  ready  for 
se. 

(b)  Let  the  man  put  his  foot  in  the  machine  and  stand  with 
11  his  weight.  The  heel  should  rest  firmly  against  the  heel 
ilock. 

It  is  important  that  the  foot  should  rest  in  the  exact  center 
)f  the  machine. 

(c)  Release  lever  which  operates  the  width  indicator,  and 
msh  the  plunger  until  the  plate  touches  the  toe.  Do  not  touch 
the  plunger  again  while  the  foot  is  in  the  machine.  Make 
sure  that  the  metal  side  pieces  touch  the  toe  joiats. 

(d)  Then  let  the  man  throw  his  entire  weight  on  the  ball 
of  his  foot,  raising  the  heel  slightly. 

(e)  The  width  is  automatically  registered  by  the  arrow.  As 
the  arrow  wavers,  following  the  action  of  the  heel  up  and 
own,  take  the  average  of  the  extremes.  (Example.  If  the 
arrow  wavers  from  width  "b"  to  width  "d"  use  width  " c") 
The  correct  size  of  the  shoe  is  indicated  by  the  pointer  on  the 
plunger  on  the  right-hand  scale. 

(f)  Measure  the  other  foot  in  the  same  manner  and  if  there 
should  be  a  difference  select  size  to  fit  the  longer  foot  and  the 
I  arrower  width. 

(g)  Oil  the  slide  under  the  device  occasionally. 

Note. — Verify  the  length  selected  by  testing  with  shoe- 
fit  ving  device. 

a)  Select  from  the  several  measuring  devices  in  the  set  the 
one  marked  with  the  size  or  half-size  corresponding  with  the 
shoes  to  be  tried  on. 

(6)  Insert  the  knol)  end  of  the  device  into  the  toe  of  the 
shoe,  springing  the  other  end  of  device  down  to  the  inner  sole, 
against  the  counter. 

(c)  The  middle  of  the  flat  spring  piece  will  lie  flat  with 
slight  pressure  of  the  foot. 


IlS  FOOT    CARE    AND    SIIOK    FITTING 

(d)  If  the  soldier,  with  pack  and  rifle  on  his  back,  can 
without  discomfort  pace  back  and  forth  in  shoes  with  device 
inserted,  the  shoes  will  be  sufficiently  long  to  allow  for  foot- 
expansion  when  device  is  withdrawn. 

Note.  — The  shoes  must  in  every  case  pass  satisfactory  the 
above  described  test. 

Shoes  of  the  size  indicated  by  measuring  machine,  fitted 
with  the  proper  shoe-fitting  device,  will  be  laced  snugly;  and 
the  soldier  with  a  40-pound  burden  on  his  back  will  throw  his 
entire  weight  upon  one  foot.  The  officer  or  enlisted  man  will 
grasp  with  his  hand  the  leather  of  the  shoe  over  the  ball.  As 
his  fingers  and  thumb  are  brought  slowly  together  over  the 
leather  the  shoe  should  feel  snugly  filled  without  apparent 
tension,  while  the  leather  should  lie  smoothly  under  the  hand. 
If  the  leather  wrinkles  under  the  grasp  of  the  hand  the  shoe  is 
too  wide  and  a  narrower  width  is  needed;  if  the  leather  seems 
tense  and  bulgy  and  the  hand  tends  to  slip  over  easily,  the 
shoe  is  too  narrow  and  a  greater  width  is  necessary.  Usually 
it  will  be  necessary  to  try  on  several  pairs  of  shoes  in  this 
manner  before  an  entirely  satisfactory  shoe  is  secured.  No 
shoes  will  be  issued  or  worn  by  enlisted  men  which  are  not 
fitted  in  accordance  with  this  order. 

When  foot  measuring  machines  and  shoe-fitting  devices 
are  not  available,  the  procedure  in  determining  the  fact  of  fit 
of  the  shoes  will  be  the  same  as  contained  in  the  preceding 
paragraph.  The  officer  or  enlisted  man  fitting  the  shoe  will 
also  press  in  the  leather  of  the  shoes  in  front  of  the  toes  to 
determine  the  existence  of  sufficient  vacant  space  in  that 
region  to  prevent  toe  injury.  Under  no  circumstances  shovild 
this  vacant  space  in  front  of  the  great  toe  be  less  than  two- 
thirds  of  an  inch,  or  the  width  of  a  man's  thumb,  nor  should 
there  be  pressure  on  top  of  the  toes. 

Measurements  will  be  taken  and  shoes  will  be  fitted  as  soon 


APPENDIX  119 

as  practicable  after  the  enlistment  or  induction  of  the  soldier 
into  the  service,  and  the  record  will  be  changed  from  time  to 
time  if  subsequent  fittings  render  a  change  necessary.     , 

Sizes  called  for  in  requisitions  ^vill  conform  to  the  record, 
and  the  fact  of  fit  shoes  and  socks  issued  on  such  requisition 
will  be  personally  verified  in  every  instance  by  a  company, 
troop,  battery,  and  detachment  officer. 

New  shoes  should  be  adapted  to  the  contours  of  the  feet  as 
soon  as  possible.  Shoe  stretchers,  with  adjustable  knobs,  to 
take  pressure  off  painful  corns  and  bunions,  are  issued  by  the 
Quartermaster  Corps. 

All  shoes  and  socks  must  be  properly  broken  in  before 
beginning  to  march.  The  following  is  suggested  but  not 
required.  The  soldier  stands  in  his  new  shoes  in  about  2  3^ 
inches  of  water  for  about  five  minutes  until  the  leather  is 
thoroughly  pliable  and  moist;  he  should  then  walk  for  about 
an  hour  on  the  level  surface,  letting  the  shoes  dry  on  his  feet, 
to  the  irregtdarities  of  which  the  leather  is  thus  molded  in  the 
same  way  as  it  was  previously  molded  over  the  shoe  last.  On 
taking  the  shoes  off  a  very  little  neat 's-foot  oil  should  be  rubbed 
into  the  leather  to  prevent  its  hardening  and  cracking. 

If  it  is  desired  to  waterproof  the  shoes  at  any  time,  a  con- 
siderable amount  of  dubbin  should  be  rubbed  into  the  leather. 

Shoes  issued  to  enlisted  men  will  be  regularly  inspected  by 
company,  troop,  battery,  and  detachment  commanders  to  see 
that  water-proofing  substance  is  applied  often,  and  that  they 
are  not  injured  by  being  placed  too  near  heating  apparatus. 
Heat  ruins  leather  and  causes  wet  leather  to  decompose 
rapidly. 

Light  woolen  or  heavy  woolen  socks  will  habitually  be  worn 
for  marching;  the  socks  will  be  large  enough  to  permit  free 
movement  of  the  toes,  but  not  so  loose  as  to  permit  of  wrin- 
kling.    Darned  socks  or  socks  with  holes,  will  not  be  worn  in 


I20  FOOT  CARE  AXU  SHOE  FITTING 

marcliing.  (This  is  not  to  be  construed,  however,  as  prohibit- 
ing soldiers  from  wearing  properly  darned  socks  while  on 
ordinar}''  duty,  at  drill,  etc.  If  on  marches  two  pairs  of  socks 
are  worn,  the  outer  pair  may  be  darned  socks.)  Woolen 
socks  will  shrink  about  one  size  after  being  washed  a  few  times. 
Proper  fitting  of  socks  must  be  secured  under  personal  super- 
vision of  a  compan}'',  troop  or  battery  oflficer. 

Company,  troop,  battery,  and  detachment  commanders, 
by  frequent  inspections  and  care  throughout  the  year,  will 
maintain  the  feet  of  their  men  in  condition  for  proper  marching. 
They  will  cause  the  proper  trimm.ing  of  nails,  removal  or 
paring  of  corns  and  callouses,  relief  of  painful  bunions,  treat- 
ment of  ingrowing  nails,  and  other  defects,  sending  serious 
cases  to  the  surgeon. 

Before  a  march  is  undertaken  by  foot  troops,  company,  troop 
battery,  and  detachment  commanders  w-ill  personally  inspect 
the  feet  of  their  men  in  condition  for  proper  marching.  They 
will  cause  the  proper  trimming  of  nails,  removal  or  paring  of 
corns  and  callouses,  relief  of  painful  bunions,  treatment  of 
ingrowing  nails,  and  other  defects,  sending  serious  cases  to  the 
surgeon. 

Before  a  march  is  undertaken  by  foot  troops,  company,  troop, 
battery,  and  detachment  commanders  will  personally  inspect 
the  bare  feet  of  their  men.  While  on  the  march  they  will 
personally  see  each  day  that  their  men  wash  their  feet  as  soon 
as  possible  after  reaching  camp,  prick  and  evacuate  blisters, 
and  cover  such  blisters  or  excoriations  with  zinc  oxide  plaster 
supplied  by  the  medical  department,  applied  hot,  dust  the 
feet  with  a  foot  powder  supplied  by  the  medical  department, 
and  put  on  clean  sock.  Hereafter,  an  undue  amount  of  foot 
injury  and  disability  from  shoes  will  be  regarded  as  evidence 
of  inefficiency  on  the  part  of  the  officers  concerned  and  as 
causes  for  investigation. 


APPENDIX  121 

A  place  will  be  provided  where  officers  may  have  shoes 
fitted  for  the  purpose  of  determining  or  verifying  the  record. 
For  the  purpose  of  fitting  unit  supply  officer  they  will  draw 
from  the  camp  quartermaster,  on  memorandtmi  receipt,  a  try- 
on  set  consisting  of  a  complete  series  of  each  size  and  width  of 
shoes  furnished  for  issue.  Shoes  of  this  series  will  be  put  in 
stock  and  issued  before  they  become  unserviceable,  and  will  be 
replaced  by  new  shoes,  keeping  the  series  always  complete. 
Company,  troop,  battery,  and  detachment  commanders  will 
report  in  writing  to  the  post  or  regimental  commander  every 
instance  of  failure  to  secure  proper  shoes  for  their  command. 
Post  or  regimental  commanders  will  investigate  the  reasons 
for  and  be  held  responsible  as  far  as  lies  in  their  power  for  the 
rectification  of  such  deficiencies. 

A  brief  record  of  the  number  of  such  reports  from  company, 
troop,  battery  and  detachment  commanders,  and  the  reason 
for  such  deficiencies  will  be  furnished  to  inspectors  at  each 
inspection  of  the  post. 

Inspections  conducted  under  the  provisions  of  paragraph 
S89,  Army  Regulations,  will  embrace  an  inquiry  into  the  man- 
ner in  which  this  order  has  been  compiled  with,  and  the  report 
of  inspections  will  include  a  statement  of  all  instances  of 
failure  on  the  part  of  company,  troop,  battery,  and  detach- 
ment commanders,  to  secure  proper  shoes  for  their  commands 
and  the  cause  of  such  failure.  (S.  R.  No.  28,  C.  No.  3,  Sept. 
20,  191S.) 

By  Order  of  the  Secretary  of  War: 

Pkyton  C.  March, 
General,  CliieJ  of  Staff. 
Official: 

P.  C.  Harris. 

Acting  Adjutant  ricneral. 


122  FOOT  CARE  AND  SHOE  FITTING 

MARINE  CORPS  ORDERS 

(a)  Marine  Corps  Orders  No.  38  (Series  1915.)  October  12, 

1915,  Par.  185. 

(b)  Marine  Corps  Orders  No.  42  (Series  1915),  December 
20,  1915,  Paragraphs  185  and  190. 

(c)  Marine  Corps  Orders  No.  37  (Series  1916),  November  4, 

1916,  Par.  258. 

Marine  Corps  orders  No.  38  (Series  19 15),  October  12,  191 5, 
Par.  185,  amended  to  read  as  follows: 

"185.  (i)  Instructions  for  fitting  of  shoes.  The  man  to  be 
fitted  shoiild  sit  on  a  chair  in  a  natviral  position  with  one  leg 
crossed  over  the  other,  as  shown  in  the  illustration  below. 

"2.  It  is  recognized  that  in  most  cases  a  man's  feet  are  not 
exactly  the  same  size,  one  being  a  little  larger  than  the  other ; 
therefore,  in  measuring  for  shoes,  the  length  of  each  foot  will 
be  measiu"ed  with  the  standard  size  stick,  furnished  by  the 
Quartennaster's  Department.  To  determine  the  approximate 
size  of  shoe  for  the  man  to  be  fitted,  two  sizes  will  be  added  to 
the  largest  measurement  shown  on  the  stick;  thus:  If  a  man's 
larger  foot  measures  five  (5)  on  the  size  stick,  add  two  (2) 
sizes  to  same,  which  will  call  for  a  number  seven  (7)  shoe;  if 
the  foot  measures  six  and  one-half  (63^),  add  two  (2)  sizes 
to  same,  which  will  call  for  a  number  eight  and  one-half 
(8M)  shoe,  and  so  forth.  Beginning  with  the  size  thus 
selected,  shoes  will  be  tried  on  until  a  satisfactory  fit  is 
secured." 

Marine  Corps  Orders  Headquarters, 

Number  42  (vSeries  1915).  U.  S.  Marine  Corps, 

Washington,  December  20,  19 15. 

190.   (i)  The  individual  cards  for  recording  sizes  of  shoes 
are  hereby  dispensed  with 


APPENDIX  123 

(2)  Paragraphs  185  (4)  and  185  (5),  Marine  Corps  Orders 
are  revoked  and  the  following  substituted: 

185.  (4)  After  determining  the  con-ect  length  and  width 
of  shoe  to  fit  a  man's  larger  foot,  entry  of  such  size  will  be  made 
in  the  man's  service-record  book  and  thereafter  no  other  size 
shoe  will  be  issued  to  him,  unless  it  is  proven  by  a  refitting  , 
that  a  dift'erent  size  is  required,  in  which  case  his  records  will 
be  changed  accordingly. 

(5)  Upon  receipt  of  this  order  all  men  will  be  measured  in 
order  to  ascertain  the  correct  size  of  shoe  they  should  wear 
and  the  necessary  notations  in  their  service-record  books  will 
be  made.     (AI.C.O.  42,  12-20-15.) 

George  Barnett, 
Major  General  Commandant. 
Office  of  the  Post  Commander, 
Marine  Barracks,  Quantico,  Va., 
January  28,   1919. 
Post  Special  Order  No.  47. 

1.  Building  No.  503  has  recently  been  fitted  U]^  and  is  now 
availal)le  for  the  purpose  of  obtaining  proper  foot  ineasurc- 
ments  for  all  men  of  this  command.  Lieutenant  S.  A.  Folsom, 
M.  C.  USN.,  at  Dispensary  No.  6,  telephone  No.  231  is  in 
charge  of  this  work. 

2.  It  is  the  intention  eventually  to  have  every  man  of 
each  organization  at  this  post  .scientifically  measured  so  as  to 
insure  a  perfect  fitting  shoe,  and  in  order  to  accomplish  this 
with  as  little  delay  and  disorganization  of  the  routine  as 
possible,  the  following  procedure  will  govern : 

(a)  Whenever  men  of  any  organization  desire  shoes,  the 
commanding  officer  of  .such  organization  will  communicate 
with  Lieutenant  Folsom  to  a.scertain  the  time  that  such 
measurements  can  be  made. 


124  FOor    I'ARK    AM)    SHOE    FITI'ING 

(6j  These  men  will  be  required  to  wash  their  feel  and  put  on 
clean  socks,  and,  accompanied  by  their  service  record  books, 
will  then  be  marched  in  heavy  marching  order  with  rifles  to 
building  503  and  measured  in  the  presence  of  a  commissioned 
officer  of  the  organization  concerned,  who  will  assist  in  making 
such  measurements  under  the  direction  of  the  medical  officer 
in  charge,  and  will  as  soon  as  same  have  been  completed  make 
a  permanent  record  in  the  service  record  books  of  the  men 
concerned. 

(c)  Thereafter,  shoes  of  the  recorded  size  only  wall  he  issued, 
and  in  submitting  clothing  requisitions  on  which  shoes  appear, 
great  care  must  be  exercised  by  the  officers  preparing  the 
requisitions  and  issuing  the  clothing,  to  see  that  this  is  strictl}' 
complied  with. 

(d)  In  case  a  man  complains  that  shoes  issued  in  accord- 
ance, with  such  measurements  do  not  fit  properly  and  are  not 
comfortable,  a  remeasurement  will  be  taken  by  the  officer  in 
charge  of  the  foot-measuring  squad  in  building  503. 

By  Order  of  Brigadier  General  Myers. 

S.  M.  Harrington, 
Major,  Ass't  A.  &  I.,  M.  C, 
Post  Adjutant. 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 

Los  Angeles 

This  book  is  DUE  on  the  last 

date  stamped  below. 


REG'D  LD-URL 

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NO^  3  0 1976 

NON-RENEWABLE 

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